Heart Failure Syndrome

Chronic heart failure is a multifaceted syndrome with diverse presentations. The initial manifestations of hemodynamic dysfunction are a reduction in stroke volume and a rise in ventricular filling pressures, perhaps in the basal state but consistently under conditions of increased systemic demand for blood flow. These changes have downstream effects on cardiovascular reflexes and systemic organ perfusion and function, which in turn stimulate a variety of interdependent compensatory responses involving the cardiovascular system, neurohormonal systems, and alterations in renal physiology.