Chronic Heart Failure: Modern Diagnostic and Treatment Approaches

Abstract

Chronic heart failure (CHF) remains one of the most pressing and widespread problems in contemporary internal medicine and cardiology due to its high morbidity, disability, and mortality rates. The disease represents the final clinical stage of various cardiovascular pathologies and is characterized by the heart's inability to pump sufficient blood to meet the body's metabolic demands. This article provides a comprehensive overview of current diagnostic and therapeutic approaches to CHF, reflecting the latest international guidelines and evidence-based practices. Special attention is given to the modern classification of heart failure based on ejection fraction (HFrEF, HFmrEF, HFpEF), and the significance of biomarkers such as NT-proBNP and troponins in early detection and prognosis. The paper also analyzes the role of imaging modalities, particularly echocardiography and cardiac MRI, in confirming the diagnosis and monitoring disease progression. Furthermore, the article delves into pharmacological treatment strategies including the use of ACE inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and the novel class of SGLT2 inhibitors, which have shown significant benefits in improving survival and quality of life. The importance of non-pharmacological interventions such as lifestyle modifications, dietary restrictions, exercise therapy, and patient education is also emphasized. In addition, the article discusses device-based therapies like implantable cardioverter-defibrillators (ICDs), cardiac resynchronization therapy (CRT), and the potential of left ventricular assist devices (LVADs) and heart transplantation in advanced stages. The multidisciplinary approach to managing CHF, involving cardiologists, general practitioners, nurses, and rehabilitation specialists, is highlighted as a key factor for improving outcomes. Overall, this article aims to update healthcare professionals on the state-of-the-art practices in diagnosing and managing chronic heart failure, bridging the gap between theoretical knowledge and clinical application. It serves as a useful resource for clinicians, researchers, and medical students interested in cardiovascular care and internal medicine.