Heart 2001;86:574-578 ( November )

Education in Heart

HEART FAILURE

What causes the symptoms of heart failure?

Andrew J S Coats

National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, Royal Brompton Hospital, London, UK

Correspondence to: Professor Andrew Coats, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK a.coats@ic.ac.uk

The first 150 words of the full text of this article appear below.

	Introduction

Chronic heart failure (CHF) is a common condition with a poor prognosis. It is associated with debilitating limiting symptoms, even with optimal modern medical management. Foremost among these symptoms is severe exercise intolerance with pronounced fatigue and dyspnoea at low exercise workloads. The UK National Health Service has highlighted it as a key target for improved treatment with the aim of symptom relief and restoration of optimal functional capacity.¹ The severity of symptomatic exercise limitation varies between patients, and this appears to bear little relation to the extent of the left ventricular systolic dysfunction measured at rest, or to markers of central haemodynamic disturbance (fig 1).² There may be several reasons for this. It may be that measurements of ventricular function at rest bear only a poor relation to changes in central haemodynamic function that occur on exercise,³ and therefore predict only poorly exercise capacity. It may be that . . . [Full text of this article]

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