Complications & Prognosis

• Acute decompensated heart failure

• Cardiorenal syndrome

• Cardiac arrhythmias

• Central sleep apnea

• Cardiogenic shock

• Stroke: due to increased risk of arterial thromboembolisms (especially with concurrent atrial fibrillation)

• Chronic kidney disease

• Cardiac cirrhosis

  • A complication of right-sided heart failure characterized by cirrhosis due to chronic hepatic vein congestion.

  • Associated with "nutmeg liver" (diffuse mottling on imaging due to ischemia and fatty degeneration).

• Venous stasis, leg ulcers

a complex syndrome in which renal function progressively declines as a result of severe cardiac dysfunction

• Systolic dysfunction → ↓ cardiac output → renal hypoperfusion → prerenal kidney failure

• Diastolic dysfunction → systemic venous congestion → renal venous congestion → ↓ transglomerular pressure gradient → ↓ GFR → ↓ kidney function

• RAAS activation → salt and fluid retention → hypertension → hypertensive nephropathy

↓ GFR, ↑ creatinine that cannot be explained by underlying kidney disease

• heart failure and renal failure management

• CHF with reduced GFR and high creatinine levels (> 3 mg/dL) is associated with a poor prognosis.

The prognosis depends on the patient, type and severity of heart disease, medication regimens, and lifestyle changes. The prognosis for patients with preserved EF is similar to or better than for patients with decreased EF. Risk stratification scales may be used to evaluate the prognosis (e.g., CHARM and CORONA risk scores).

• Elevated BNP

• Hyponatremia

• Systolic BP < 120 mm Hg

• Diabetes

• Anemia

• Weight loss or underweight

• S3 heart sound

• Implantable cardioverter-defibrillator use

• Frequent hospitalizations due to CHF

• Stage I: ∼ 95%

• Stage II: ∼ 85%

• Stage III: ∼ 85%

• Stage IV: ∼ 35%