Heart Failure: A Primary Care Provider Review

Authors

Tracy L. Kirkland, University of LynchburgFollow

Specialty

Primary Care

Advisor

Dr. Munsell

Abstract

ABSTRACT

Heart failure is a growing concern globally and a leading cause of hospitalizations in the United States, with a projection of 8 million patients diagnosed by 2030. Heart failure (HF) causes debilitating symptoms, including dyspnea, exercise intolerance, fatigue, and edema. Medical therapy and lifestyle modifications, including exercise and fluid restriction, constitute first-line management to reduce hospitalizations and improve quality of life. Heart failure is categorized by left ventricular ejection fraction (LVEF), as measured by echocardiogram. These three main classes are reduced ejection fraction, in which the LVEF is less than 40% (HFrEF), mildly reduced ejection fraction, in which the LVEF is 40-49% (HFmrEF), and preserved ejection fraction, in which the LVEF is greater than 50% (HFpEF). The purpose of this review is to support primary care providers by outlining heart failure classifications, clinical presentations, risk factors, and evidence-based treatment strategies.

Common causes of heart failure include ischemia (decreased blood flow), arrhythmias, obesity, and metabolic syndromes. A comprehensive literature search of databases, including PubMed and Google Scholar, identified review articles on each type of heart failure, comorbidities associated with increased risk of heart failure, and research studies evaluating pharmacological treatment. The clinical application of randomized controlled trials, including the EMPEROR-REDUCED (The Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction) and RALES (Randomized Aldactone Evaluation Study), will be discussed. Despite recent evidence suggesting symptomatic benefit from medical therapy, there remains a need for future research in HFpEF, given the limited options to reduce cardiovascular mortality in this population. In light of the increasing prevalence of heart failure, primary care providers must proactively evaluate and manage these patients to reduce morbidity and mortality.

Recommended Citation

Kirkland TL. Heart Failure: A Primary Care Provider Review. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2025; 7(3).