Recognizing signs and symptoms of acute HF “These symptoms include: • shortness of breath (dyspnea), found to be evident in 92% of acute heart failure patients • peripheral oedema (in 35%) • cough (in 33%) • breathing difficulty when lying flat (orthopnea, in 30%) • chest pain (in 29%) • nocturnal dyspnea (in 28%) • fatigue (in 17%) • palpitations (in 7%) Shortness of breath, said Professor Follath, is by far the most common presenting symptom, and families should recognise that it can be described in various ways – from "suffocation" to "tight chest" to "heavy breathing". At the same time, he warned that many elderly patients with heart failure may have co-existing conditions with non-cardiac symptoms, and these may be misleading. Careful instruction, therefore, in a simple understandable way is essential to ensure early warning and speedy treatment.”

Mild hyperkalemia and outcomes in chronic heart failure: A propensity matched study. (Int J Cardiol. 2009) “CONCLUSION: Serum potassium 4-4.9 mEq/L is optimal and 5-5.5 mEq/L appears relatively safe in HF. Despite lack of an intrinsic association , the bivariate association of mild-hyperkalemia with mortality suggests that it may be useful as a biomarker of poor prognosis in HF.”

Risk Of Heart Failure Doubled By Obesity And Diabetes -- Patients With Both Conditions 'Very Difficult' To Treat “The pathways by which obesity plays such a role in heart failure are not yet fully understood, but have been shown to have an indirect effect via hypertension, or heart attack, or diabetes - and a direct effect on the heart muscle itself. "We know that the underlying changes in the structure and function of the heart may be different in obese and non-obese patients with heart failure," says Professor McMurray. An even more "intriguing" suggestion, he added, is that adipose cells might act as an endocrine tissue, secreting substances which may have a harmful effect on heart tissue and blood vessels. The relationship between diabetes and heart failure is also a subject of investigation, with the risk of heart failure doubled in diabetics. Heart failure patients with diabetes also have worse symptoms, a higher risk of hospitalisation and a greater risk of death than those without diabetes - suggesting that the underlying pathophysiology of heart failure may be different in diabetics and non-diabetics.”