Heart Failure & Valvular Disorders

Heart failure is classified by ejection fraction (reduced vs. preserved) and by side: left-sided failure backs up into the lungs (dyspnea, crackles, orthopnea, frothy pink sputum in acute pulmonary edema), while right-sided failure backs up into the systemic circulation (peripheral/dependent edema, jugular venous distension, hepatomegaly, ascites). Core medication classes reduce the heart's workload and improve outcomes: ACE inhibitors/ARBs and beta-blockers slow disease progression, diuretics manage fluid overload, and ARNI (angiotensin receptor-neprilysin inhibitor) combinations are increasingly first-line for reduced-ejection-fraction failure. Daily weights (same time, same scale, same clothing) are the single most sensitive way to catch fluid retention before symptoms worsen — teach patients to call their provider for a gain of roughly 2–3 lbs in a day or 5 lbs in a week.