Sandbox Rim: Difference between revisions
Rim Halaby (talk | contribs) |
Rim Halaby (talk | contribs) |
||
Line 83: | Line 83: | ||
{{Family tree/start}} | {{Family tree/start}} | ||
{{Family tree | | | | | | | A01 | | | | | | | | | | A01= '''What is the stage of heart failure (HF)?'''}} | {{Family tree | | | | | | | A01 | | | | | | | | | | A01= <div style="float: left; text-align: left; width: 17em; padding:1em;">'''What is the stage of heart failure (HF)?''' </div>}} | ||
{{Family tree | |,|-|-|-|v|-|^|-|-|-|v|-|-|-|-|.| }} | {{Family tree | |,|-|-|-|v|-|^|-|-|-|v|-|-|-|-|.| }} | ||
{{Family tree | B01 | | B02 | | | | B03 | | | | B04 | | B01= '''Stage A''' <br>''At high risk for HF but without structural heart disease or symptoms of HF''| B02= '''Stage B''' <br> ''Structural heart disease but without signs or symptoms of HF''| B03= '''Stage C '''<br>''Structural heart disease with prior or current symptoms of HF''| B04= '''Stage D''' <br> ''Refractory HF requiring specialized interventions'' }} | {{Family tree | B01 | | B02 | | | | B03 | | | | B04 | | B01= '''Stage A''' <br>''At high risk for HF but without structural heart disease or symptoms of HF''| B02= '''Stage B''' <br> ''Structural heart disease but without signs or symptoms of HF''| B03= '''Stage C '''<br>''Structural heart disease with prior or current symptoms of HF''| B04= '''Stage D''' <br> ''Refractory HF requiring specialized interventions'' }} | ||
{{Family tree | |!| | | |!| | | | | |!| | | | | |!| | | }} | {{Family tree | |!| | | |!| | | | | |!| | | | | |!| | | }} | ||
{{Family tree | C01 | | C02 | | | | C03 | | | | C04 | | C01= | {{Family tree | C01 | | C02 | | | | C03 | | | | C04 | | C01=<div style="float: left; text-align: left; width: 17em; padding:1em;"> | ||
* Encourage healthy lifestyle and exercise | * Encourage healthy lifestyle and exercise | ||
* Treat hypertension ( I-A) | * Treat hypertension ( I-A) | ||
Line 95: | Line 95: | ||
* Avoid tobacco (I-C) | * Avoid tobacco (I-C) | ||
* Avoid cardiotoxic agents (I-C) | * Avoid cardiotoxic agents (I-C) | ||
* Administer ACE-I if HTN, DM, CVD, PAD | * Administer ACE-I if HTN, DM, CVD, PAD </div> | ||
| C02= | | C02=<div style="float: left; text-align: left; width: 17em; padding:1em;"> | ||
* Encourage healthy lifestyle and exercise | * Encourage healthy lifestyle and exercise | ||
* Treat hypertension ( I-A) | * Treat hypertension ( I-A) | ||
Line 108: | Line 108: | ||
* Administer beta-blockers if history of MI or ACS and reduced EF to reduce mortality (I-B), in all reduced EF to prevent symptoms (I-C) | * Administer beta-blockers if history of MI or ACS and reduced EF to reduce mortality (I-B), in all reduced EF to prevent symptoms (I-C) | ||
* Administer statins if history of MI or ACS to prevent symptoms (I-A) | * Administer statins if history of MI or ACS to prevent symptoms (I-A) | ||
* Consider ICD placement to prevent sudden death if asymptomatic ischemic cardiomyopathy, > 40 days post-MI, LVEF <= 30%, on adequate medical therapy, and good 1 year survival | * Consider ICD placement to prevent sudden death if asymptomatic ischemic cardiomyopathy, > 40 days post-MI, LVEF <= 30%, on adequate medical therapy, and good 1 year survival </div> | ||
| C03= | | C03= <div style="float: left; text-align: left; width: 17em; padding:1em;"> | ||
''Non-medical therapy in all patients:'' | ''Non-medical therapy in all patients:'' | ||
* Exercise training (I-A) | * Exercise training (I-A) | ||
Line 117: | Line 117: | ||
* Treatment of HTN, dyslipidemia, obesity, DM | * Treatment of HTN, dyslipidemia, obesity, DM | ||
* Avoid tobacco (I-C) | * Avoid tobacco (I-C) | ||
* Avoid cardiotoxic agents | * Avoid cardiotoxic agents </div> | ||
| C04= | | C04=<div style="float: left; text-align: left; width: 17em; padding:1em;">'''''Fluid restriction:''''' | ||
'''''Fluid restriction:''''' | |||
Restriction to 1.5 to 2 L/d particularly in case of hyponatremia (IIa-C) | Restriction to 1.5 to 2 L/d particularly in case of hyponatremia (IIa-C) | ||
Line 135: | Line 134: | ||
'''''Cardiac transplantation''''' | '''''Cardiac transplantation''''' | ||
* Refractory to medical therapy, device, and surgery (I-C)}} | * Refractory to medical therapy, device, and surgery (I-C) </div>}} | ||
{{Family tree/end}} | {{Family tree/end}} | ||
What is the ejection fraction? | What is the ejection fraction? | ||
B03= '''Stage C HFrEF'''<br>''Structural heart disease with prior or current symptoms of HF and reduced ejection fraction''| B04= '''Stage C HFpEF''' <br> ''Structural heart disease with prior or current symptoms of HF and preserved ejection fraction''} | B03= '''Stage C HFrEF'''<br>''Structural heart disease with prior or current symptoms of HF and reduced ejection fraction''| B04= '''Stage C HFpEF''' <br> ''Structural heart disease with prior or current symptoms of HF and preserved ejection fraction''} |
Revision as of 19:44, 12 March 2015
Treatment of Acute Decompensation of Heart Failure
Initial stabilization: Assess congestion and perfusion: Admit for in-hospital treatment if: Identify precipitating factor and treat accordingly:
❑ COPD Treat congestion and optimize volume status: Venodilators Treat low perfusion: VTE prevention: Chronic medical therapy: Management of hyponatremia: | |||||||||
Chronic Treatment for Heart Failure
What is the stage of heart failure (HF)? | |||||||||||||||||||||||||||||||||||||||||
Stage A At high risk for HF but without structural heart disease or symptoms of HF | Stage B Structural heart disease but without signs or symptoms of HF | Stage C Structural heart disease with prior or current symptoms of HF | Stage D Refractory HF requiring specialized interventions | ||||||||||||||||||||||||||||||||||||||
| Additional measures in selected patients:
| Non-medical therapy in all patients:
| Fluid restriction:
Restriction to 1.5 to 2 L/d particularly in case of hyponatremia (IIa-C) Inotropes
Mechanical circulatory support (MCS)
Cardiac transplantation
| ||||||||||||||||||||||||||||||||||||||
What is the ejection fraction?
B03= Stage C HFrEF
Structural heart disease with prior or current symptoms of HF and reduced ejection fraction| B04= Stage C HFpEF
Structural heart disease with prior or current symptoms of HF and preserved ejection fraction}