Muhammad Ijaz Bhatti, Majid Kaleem, Asif Hanif.
Heart Failure; Frequency of Different Factors Causing Decompensation in Preveiously Compensated Heart Failure.
Professional Med J Jan ;25(6):865-9.

Objectives: To identify factors which cause deterioration with worsening of symptoms in previously stable heart failure patients. Study design: Descriptive case series Setting: Gulab Devi Chest Hospital, Lahore. Duration: 01-04-2017 to 30-09-2017. Patients and Methods: The study was done on 100 patients diagnosed with LV systolic dysfunction or cardiomyopathy with LVEF<40%. Patients were examined regarding clinical signs of decompensation and detailed history was taken to probe the cause of decompensation. All information was noted down on a pre-defined questionnaire. Mean ± S.D was applied for quantitative data like age and LVEF. Frequency (%) was used for qualitative data like gender. Results: Non compliance to drugs was the most common cause of decompensation (56%), amongst them 73.21% cases were noncompliant due to poor awareness about the importance of continuing use of medicines. Infection was the second common precipitating factor (51%), where chest infection was the most common cause in 74.51% cases. Other causes of decompensation were ischaemia (28%), renal impairment (36%), and arrhythmias (23%) while more than one precipitating factors were found in 41% of cases. Conclusion: Multiple factors can trigger deterioration in patients with previously stable heart failure. Recognition of these factors is important for good long term outcome in these patients.

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