Hero Banner. Heart failure.
Hero Banner. Heart failure.

Heart failure

Heart failure (HF) is defined by the European Society of Cardiology as a clinical syndrome characterised by symptoms such as breathlessness, ankle swelling and fatigue, that may be accompanied by signs such as elevated jugular venous pressure, pulmonary crackles and peripheral oedema. HF is caused by a structural and/or functional cardiac abnormality, and results in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress.1

HF can be differentiated into three types based on the measurement of left ventricular ejection fraction (LVEF): HF with preserved ejection fraction (HFpEF), HF with mildly reduced ejection fraction (HFmrEF) and HF with reduced ejection fraction (HFrEF).1

HF is usually classed as chronic (CHF) or acute (AHF). CHF describes an established diagnosis of HF or a more gradual onset of symptoms. If CHF deteriorates, whether suddenly or slowly, the episode may be described as ‘decompensated’ HF. This can result in hospital admission or treatment with intravenous diuretic therapy in an outpatient setting. AHF refers to a rapid or gradual onset of symptoms and/or signs of HF, HF signs and symptoms that are severe enough for the patient to seek urgent medical attention. This leads to an unplanned hospital admission or an emergency department visit. 

Infographic showing eight clinical signs and symptoms of heart failure: atrial fibrillation, elevated JVP, weight gain or loss, fatigue, breathlessness, ankle swelling, loss of appetite and nocturnal cough.

Types of HF
The main terminology used to describe HF is based on the measurement of LVEF.1 Differentiating patients this way is important due to different underlying aetiologies, demographics, co-morbidities and response to therapies.1

Epidemiology
There are around 90,000 people in Ireland living with HF. Both the incidence and prevalence of HF increase with age. The majority of HF cases are in the over-65s.2 

Box with the text ‘HF with preserved ejection fraction (HFpEF). Normal LVEF, typically considered as ≥50%¹.’
Box with the text ‘HF with mid-range ejection fraction (HFmrEF). Moderately reduced LVEF, 41-49%¹.’
Box with the text ‘HF with reduced ejection fraction (HFrEF). Reduced LVEF, typically considered as ≤40%¹.’

AF, atrial fibrillation; AHF, acute heart failure; CHF, chronic heart failure; HF, heart failure; HFmrEF, heart failure with mildly reduced ejection fraction; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; JVP, jugular venous pressure; LVEF, left ventricular ejection fraction. 

References

  1. McDonagh TA, et al. Eur Heart J 2021;42(36):3599–3726.

  2. Global Heart Hub. Irish Heart Failure Barometer 2019. Available at: https://globalhearthub.org/wp-content/uploads/2019/05/HF_Barometer-Irish.pdf [Accessed April 2026].

 

IE11526378 | April 2026

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