HEART FAILURE: CURRENT CHALLENGES IN EARLY DIAGNOSIS, TREATMENT, AND REDUCTION OF HOSPITALIZATIONS

Abstract

Heart failure is a complex clinical syndrome of major public health relevance, associated with significant rates of morbidity, mortality, recurrent hospitalizations, and impaired quality of life. Despite the advances achieved in recent decades, challenges remain regarding early recognition of the disease, adequate definition of the patient's clinical profile, implementation of recommended therapies, and prevention of decompensation. This chapter aims to discuss the main contemporary challenges related to early diagnosis, treatment, and reduction of hospitalizations due to heart failure, highlighting strategies that can contribute to more effective care. This is a narrative literature review based on scientific publications and national and international guidelines related to heart failure management. The literature demonstrates that diagnosis may be challenging due to the heterogeneous clinical presentation and the presence of nonspecific signs and symptoms, particularly among older adults and individuals with multiple comorbidities. In this context, clinical assessment combined with complementary tests, biomarkers, and imaging methods plays a fundamental role in the identification and classification of the disease. Regarding treatment, recent evidence demonstrates the benefits of pharmacological approaches capable of reducing mortality and hospitalizations, particularly in patients with heart failure with reduced ejection fraction, although difficulties related to access, adherence, and therapeutic optimization still limit outcomes in clinical practice. Furthermore, health education, multidisciplinary follow-up, management of comorbidities, early recognition of signs of decompensation, and appropriate planning of care transitions after hospital discharge are relevant strategies for reducing readmissions. It is concluded that addressing heart failure requires timely diagnosis, evidence-based treatment, and continuous and individualized follow-up, with integration among different levels of health care, aiming to reduce preventable hospitalizations, improve quality of life, and promote better clinical outcomes.