AstraZeneca has delivered this text only version of the course to serve those users who have difficulty accessing the interactive version.
You can access it here: Demo Interactive Version
Further information can be found at: "Heart Failure" main page
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Welcome to “Heart Failure”.
Before beginning, please take a moment to read the course details.
Course Length: Approximately 7 hours. Your
time may vary based on modem speed, prerequisite knowledge and
other factors.
Prerequisites: Anatomy and Physiology of the
Cardiovascular System.
Date Published: April 2004
Valid Until: January, 2007
Heart failure is a very serious, debilitating disease that causes significant morbidity and mortality in the U.S. Research on the abnormal physiology that underlies heart failure has resulted in new treatment options. This course, Heart Failure, is divided into five sections.
The first section, EPIDEMIOLOGY, describes the impact of heart failure on society in terms of prevalence, mortality, morbidity, and economic costs.
The second section, AETIOLOGY, explains the various mechanisms that may initiate the development of heart failure.
The third section, PROGNOSIS, describes the different stages in the development of heart failure, factors that may affect disease progression, and its possible outcomes.
The fourth section, DIAGNOSIS, describes the signs and symptoms of heart failure, how it is diagnosed, and how the degree and progression of heart failure is evaluated.
The last three sections, TREATMENT I - III, cover the pharmacologic and non-pharmacologic treatment and follow-up of heart failure patients, the treatment of underlying diseases, and other therapies.
Heart failure affects an estimated 1.5%-2.0% of the U.S. population, and is the only major cardiovascular disorder that is increasing in incidence. This section, 'Epidemiology', deals with morbidity and mortality due to heart failure, and its prevalence.
These are the objectives for this section. You will be tested on these objectives in the final assessment.
After you finish this section, you should be able to:
Despite recent therapeutic advances, heart failure continues to cause excessive morbidity and mortality and is the only major cardiovascular disorder that is increasing in incidence and prevalence. This is likely due to two factors: the rising average age of most of the world’s population, and improved treatments for myocardial infarction (MI) and hypertension that allow these patients to live longer and develop heart failure.
As of 1999, approximately 4.6 million patients in the United States, or about 1.5%-2.0% of the population, had chronic heart failure. A significant percentage of men and women have heart failure, especially in older groups. An estimated 75% of chronic heart failure cases also have diagnosed hypertension.
Each year, approximately 400,000 new patients are diagnosed with chronic heart failure, including an incidence of about 1% of the population older than age 65.
In comparison, two of the most common cancers (prostate and breast cancer), each occur at an incidence of only about half that of heart failure. In men, about 179,000 new cases of prostate cancer were expected in 1999. In women, breast cancer is most common, with about 175,000 new cases in 1999.
Chronic heart failure is the most frequent cause of hospitalization for those age 65 and older. Total hospital discharges for chronic heart failure rose from 377,000 in 1979 to 870,000 in 1996. In addition, deaths attributable to heart failure rose by almost 120% during the same period.
Heart failure kills more people than cancer does. This lesson presents a comparison of mortality statistics for heart failure and cancer.
In 1998, the total number of deaths due to cardiovascular disease was almost twice as high as those due to cancer, and more than 70 times the number due to AIDS.
Approximately 250,000 deaths are directly or indirectly attributed to chronic heart failure each year, mostly due to progressive pump failure and sudden cardiac death. This is more than the number of yearly deaths attributed to lung, prostate, and breast cancer combined.
The 5-year mortality rate for heart failure after diagnosis is about 50%, and the 1-year mortality rate for severe heart failure is also about 50%. In comparison, the relative 5-year mortality rate for all cancers combined is almost 40%.
The risk of death annually is 5%-10% in patients with mild symptoms, and 30%-40% in patients with advanced disease.