Physiological— the inability of the heart to pump sufficient oxygenated blood to the metabolizing tissues despite an adequate filling pressure. Working clinical definition— the clinical syndrome consisting of symptoms such as breathlessness, fatigue, and swelling of the ankles caused by cardiac dysfunction. Chronic heart failure (hF) can be caused by any type of cardiac dysfunction and is most commonly attributable to left ventricular dysfunction. Only rarely does a patient present with hF as a result of isolated right- ventricular (rV) dysfunction. rV dysfunction is usually secondary to left ventricular (LV) dysfunction and its sequelae.
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