Fast Five Quiz: Heart Failure Comorbidities

Ioana Dumitru, MD


July 15, 2021

Figure 1. Color enhanced x-ray of the enlarged heart of a 55-year-old woman with congestive heart failure.

There is a correlation between HF severity and degree of cognitive dysfunction. Cognitive dysfunction can present in patients with HF across the spectrum of disease, from mild cognitive impairment to vascular dementia and Alzheimer's disease. Some form of cognitive dysfunction is observed in almost half of all patients with chronic HF, but it is because of this variability — and infrequent screening of cognitive function — that the comorbidity remains underrecognized.

Spirometry testing to diagnose COPD is not always conclusive because some patients, particularly those with unstable disease, may present with pulmonary congestion.

In many patients with chronic HF, sleep-disordered breathing cannot be easily diagnosed on the basis of clinical characteristics; therefore, screening may be conducted using a nasal flow meter, either with or without pulse oximetry.

In patients with chronic HF, circulating ferritin levels might be higher owing to chronic low-grade inflammation. On the other hand, transferrin saturation can be artificially increased owing to impaired hepatic transferrin synthesis in the context of cardiac decompensation. Iron deficiency is generally diagnosed on the basis of a serum ferritin level < 100 μg/L, or a serum ferritin level of 100-300 μg/L with transferrin saturation < 20%.

Learn more about treatment of HF.


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