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New Definition and Best Assessment of Heart Failure: A First-in-Man Application of a New Technique Thach Nguyen MD FACC FSCAI Methodist Hospital, Merrillville IN At the Vietnam Heart Association Meeting October 10th 2016 Symptoms and Signs of Heart Failure Are Non Specific The same symptoms and signs can be found in Heart failure, COPD, Chronic kidney failure Cirrhosis of the liver Pulmonary hypertension Pericarditis When I am consulted to see a patient with possible heart failure, after I examine the patient, what is my answer? I don’t know whether the patient has HF however what I am sure is whether the patient has fluid overload Diagnosis of heart failure, Extent of internal acute blood loss, Diagnosis of syncope Diagnosis of orthostatic hypotension, Confirm HF in patient with COPD, Confirm HF with chronic kidney dis Confirm HF in patient with cirrhosis Confimr fluid overload in patient with normal EF (misnomer diastolic HF) Extravascular Fluid Overload Intravascular Fluid Overload This classification is better than the ACC/AHA, NYHA classification Intr aV Extra V EF Patient Profile - - High A Normal heart, no fluid overload - + High B Normal heart with fluid overload (Healthy sick) + - High C Compromised LV function (e.g stiff LV due to age) (easy to get sick) (Vulnerable, mildly sick person) + + High D Symptomatic compromised LV diastolic function (stiff LV due to age) (Really sick, Recover fast and stay healthy for long time) Patient with Fluid overload Femoral Artery Much larger femoral vein ROAD MAP Disease Progress Toward recovery ROAD MAP Disease Progress Toward recovery Problems in Premature Discharges and Early Readmissions B1 (I- E+) C1 (I+ E-) D1 (I+E+ Diagnosis of heart failure, Extent of internal acute blood loss, Diagnosis of syncope Diagnosis of orthostatic hypotension, Confirm HF in patient with COPD, Confirm HF with chronic kidney dis Confirm HF in patient with cirrhosis Confimr fluid overload in patient with normal EF (misnomer diastolic HF) This classification is better than the ACC/AHA, NYHA classification Intr aV Extra V EF Patient Profile - - High A Normal heart, no fluid overload - + High B Normal heart with fluid overload (Healthy sick) + - High C Compromised LV function (e.g stiff LV due to age) (easy to get sick) (Vulnerable, mildly sick person) + + High D Symptomatic compromised LV diastolic function (stiff LV due to age) (Really sick, Recover fast and stay healthy for long time) Patient with Fluid overload Femoral Artery Much larger femoral vein Thank You Contact for new clinical trial: thachnguyen 2000@yahoo.com ... LV diastolic function (stiff LV due to age) (Really sick, Recover fast and stay healthy for long time) Profile A: No Extravascular No Intravascular Fluid Overload normal heart (Not Sick) Profile