Clinical features

Clinical manifestations need not necessarily be apparent for a considerable degree of ventricular dysfunction to be present. Symptoms are usually manifest as breathlessness and fatigue resulting in limited exercise capacity (systolic dysfunction) and/or peripheral and pulmonary edema with orthopnea (diastolic dysfunction). However, severe pump failure will produce symptoms at rest, with evidence of impaired organ perfusion (oliguria, confusion, drowsiness) and/or lung congestion. Cardiogenic shock refers to the situation where oxygen supply by the heart is inadequate to prevent significant tissue hypoxia. This term is usually applied in error to describe a coexisting hypotensive state which need not be present.

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