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PANCE® is a registered trademark of the National Commission on Certification of Physician Assistants (NCCPA). This application is an independent study resource and is not affiliated with, sponsored by, or endorsed by the NCCPA.

For educational use only. Content is AI-generated, may contain errors, and is not medical advice — always verify against current primary sources and faculty guidance before clinical use.

HomeCardiovascularHeart Failure (HFrEF)
🫀

Heart Failure (HFrEF)

Cardiovascular · ~11% of blueprint
🔬Pathophysiology
Reduced contractility (EF ≤40%) → ↓CO → neurohormonal (RAAS/SNS) activation → volume overload & remodeling.
🩺Signs & Symptoms
Dyspnea on exertion, orthopnea, PND, bilateral crackles, JVD, S3 gallop, peripheral edema.
🎯Gold Standard Diagnosis
Echocardiography (assesses EF). BNP/NT-proBNP supports dx and tracks severity.
💊First-line Treatment
GDMT: ARNI (or ACEi/ARB) + beta-blocker + MRA + SGLT2 inhibitor; loop diuretic for congestion.
Drug cardsLisinoprilCarvedilolSpironolactoneEmpagliflozinFurosemide
High-Yield Pearl

The 4 pillars (ARNI, BB, MRA, SGLT2i) reduce mortality. Diuretics treat symptoms, not mortality.

Sources

Reviewed September 2026
  1. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure — AHA/ACC/HFSA, 2022
  2. StatPearls: Heart Failure — NCBI Bookshelf / StatPearls, 2025
  3. StatPearls: Heart Failure — Table 2, Classification of HF by LVEF — NCBI Bookshelf / StatPearls, 2025

Checked against the guideline or standard reference the exam keys to. If it has moved, use Report an error below.

More Cardiovascular conditions

  • Acute Coronary Syndrome (STEMI)
  • Acute Pericarditis
  • Aortic Dissection
  • Aortic Stenosis
  • Atrial Fibrillation
  • Deep Vein Thrombosis
  • Hyperlipidemia
  • Hypertension (Essential)
  • Hypertrophic Cardiomyopathy
  • Infective Endocarditis
  • Mitral Regurgitation
  • Peripheral Arterial Disease
All Cardiovascular