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Poole-Wilson PA, Buller NP. Causes of symptoms in chronic congestive heart failure and implications for treatment. Am J Cardiol. 1988;62(2):31A-34Adoi: 10.1016/s0002-9149(88)80082-1.
Poole-Wilson, P. A., & Buller, N. P. (1988). Causes of symptoms in chronic congestive heart failure and implications for treatment. The American journal of cardiology, 62(2), 31A-34A. https://doi.org/10.1016/s0002-9149(88)80082-1
Poole-Wilson, P A, and Buller, N P. "Causes of symptoms in chronic congestive heart failure and implications for treatment." The American journal of cardiology vol. 62,2 (1988): 31A-34A. doi: https://doi.org/10.1016/s0002-9149(88)80082-1
Poole-Wilson PA, Buller NP. Causes of symptoms in chronic congestive heart failure and implications for treatment. Am J Cardiol. 1988 Jul 11;62(2):31A-34A. doi: 10.1016/s0002-9149(88)80082-1. PMID: 3291593.
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Elsevier Science

Am J Cardiol. 1988 Jul 11;62(2):31A-34A. doi: 10.1016/s0002-9149(88)80082-1.

Causes of symptoms in chronic congestive heart failure and implications for treatment.

The American journal of cardiology

P A Poole-Wilson, N P Buller

Affiliations

  1. Cardiothoracic Institute, London, United Kingdom.

PMID: 3291593 DOI: 10.1016/s0002-9149(88)80082-1

Abstract

The most common symptoms of patients with heart failure are shortness of breath and fatigue. The causes of these symptoms may be different in various entities encompassed by the general term heart failure, such as acute pulmonary edema, circulatory collapse and chronic heart failure. In patients with acute heart failure, shortness of breath is closely related to left atrial pressure. In patients with chronic heart failure, optimally treated with diuretics, the body fluid compartments are usually of normal size. Recent work strongly suggests that, in such patients, central hemodynamic abnormalities are not the sole determinants of symptoms. Impaired vasodilation and altered metabolism in skeletal muscle, circulating metabolites and pulmonary ventilation-perfusion mismatch with consequent increased physiologic dead space may all contribute to the genesis of symptoms. Consequently, it may be possible to alleviate symptoms by treatments that are not aimed directly at improving central hemodynamics. Whether such an approach could also modify prognosis is unknown.

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