Congestive heart failure: Difference between revisions
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== Treatment == | == Treatment == | ||
===Treatment of Heart failure with reduced ejection fraction=== | === Treatment of Heart failure with reduced ejection fraction === | ||
: '''[[Congestive heart failure Pharmacological treatments for patients with heart failure with reduced ejection fraction|Pharmacological treatments for patients with heart failure with reduced ejection fraction]]''': | : '''[[Congestive heart failure Pharmacological treatments for patients with heart failure with reduced ejection fraction|Pharmacological treatments for patients with heart failure with reduced ejection fraction]]''': | ||
*'''All patients:''' [[Congestive heart failure ACE inhibitors|ACE Inhibitors]] | [[Congestive heart failure beta blockers|Beta Blockers]] | [[Congestive heart failure aldosterone antagonists|Aldosterone Antagonists]] | [[Congestive heart failure angiotensin receptor-neprilysin inhibitor|Angiotensin Receptor-Neprilysin Inhibitor]] | [[Congestive heart failure Sodium-glucose co-transporter 2 inhibitors|Sodium-glucose co-transporter 2 inhibitors]] | | *'''All patients:''' [[Congestive heart failure ACE inhibitors|ACE Inhibitors]] | [[Congestive heart failure beta blockers|Beta Blockers]] | [[Congestive heart failure aldosterone antagonists|Aldosterone Antagonists]] | [[Congestive heart failure angiotensin receptor-neprilysin inhibitor|Angiotensin Receptor-Neprilysin Inhibitor]] | [[Congestive heart failure Sodium-glucose co-transporter 2 inhibitors|Sodium-glucose co-transporter 2 inhibitors]] | | ||
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: '''[[Congestive heart failure Cardiac rhythm management for patients with heart failure with reduced ejection fraction|Cardiac rhythm management for patients with heart failure with reduced ejection fraction]]''': | : '''[[Congestive heart failure Cardiac rhythm management for patients with heart failure with reduced ejection fraction|Cardiac rhythm management for patients with heart failure with reduced ejection fraction]]''': | ||
*[[Implantable cardioverter defibrillator]] | [[Cardiac resynchronization therapy]] | *[[Implantable cardioverter defibrillator]] | [[Cardiac resynchronization therapy]] | ||
=== Treatment of Heart failure with mildly reduced ejection fraction === | |||
[[Angiotensin-converting enzyme inhibitors]] | [[Angiotensin receptor II type 1 blockers]] | [[Beta-blockers]] | [[Mineralocorticoid receptor antagonists]] | [[Angiotensin receptor-neprilysin inhibitor]] | Other drugs | Devices | |||
=== Treatment of Heart failure with preserved ejection fraction === | === Treatment of Heart failure with preserved ejection fraction === | ||
=== Management of Acute heart failure === | === Management of Acute heart failure === | ||
[[Oxygen therapy and/or ventilatory support]] | [[Oxygen therapy and/or ventilatory support]] | ||
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[[Short-term mechanical circulatory support]] | [[Short-term mechanical circulatory support]] | ||
[[Pre-discharge assessment and post-discharge management planning]] | [[Pre-discharge assessment and post-discharge management planning]] | ||
===Managementof Advanced heart failure=== | ===Managementof Advanced heart failure=== | ||
[[Pharmacological therapy]] | [[Pharmacological therapy]] | ||
[[Renal replacement]] | |||
[[Mechanical circulatory support]] | [[Mechanical circulatory support]] | ||
[[Heart transplantation]] | [[Heart transplantation]] | ||
[[Symptom control and end-of-life care]] | [[Symptom control and end-of-life care]] | ||
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Weight Loss | Weight Loss | ||
Activity, Exercise Prescription, and Cardiac Rehabilitation | Activity, Exercise Prescription, and Cardiac Rehabilitation | ||
[[Patient education, self-care and lifestyle advice]] | [[Exercise rehabilitation]] | ==== [[Congestive heart failure and exercise|Exercise Training]] ==== | |||
[[Follow-up of chronic heart failure]] | |||
[[Telemonitoring]] | |||
:'''[[Congestive heart failure treatment of underlying causes|Treatment of underlying causes]] | [[Congestive heart failure treatment of associated conditions|Associated conditions]]''' | |||
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:'''[[Congestive heart failure drugs to avoid|Drugs to Avoid]] | [[Congestive heart failure drug interactions|Drug Interactions]]''' | :'''[[Congestive heart failure drugs to avoid|Drugs to Avoid]] | [[Congestive heart failure drug interactions|Drug Interactions]]''' | ||
:'''[[Congestive heart failure | : '''[[Congestive heart failure with preserved EF pharmacotherapy|Chronic Pharmacotherapy in HFpEF]] | ||
==== Surgical Therapy: ==== | ==== Surgical Therapy: ==== | ||
Revision as of 13:28, 18 September 2021
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Resident Survival Guide |
| Congestive Heart Failure Microchapters |
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Pathophysiology |
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Differentiating Congestive heart failure from other Diseases |
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Diagnosis |
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Treatment |
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Medical Therapy: |
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Surgical Therapy: |
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ACC/AHA Guideline Recommendations
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Specific Groups: |
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Congestive heart failure On the Web |
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Risk calculators and risk factors for Congestive heart failure |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2], Seyedmahdi Pahlavani, M.D. [3] Syed Hassan A. Kazmi BSc, MD [4]
Synonyms and keywords: CHF; pump failure; left heart failure; chronic heart failure; acute heart failure; LV dysfunction; LV failure; impaired filling; reduced cardiac output; HFpEF; HFrEF; heart failure preserved ejection fraction; heart failure reduced ejection fraction; decompensated heart failure; acute decompensated heart failure; ADHF
Overview
Classification
Pathophysiology
Systolic dysfunction | Diastolic dysfunction | HFpEF | HFrEF
Causes
Differentiating Chronic Heart Failure from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Clinical Assessment | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | Echocardiography | Cardiac MRI | Exercise Stress Test | Myocardial Viability Studies | Cardiac Catheterization | Invasive hemodynamic monitoring
Treatment
Treatment of Heart failure with reduced ejection fraction
- All patients: ACE Inhibitors | Beta Blockers | Aldosterone Antagonists | Angiotensin Receptor-Neprilysin Inhibitor | Sodium-glucose co-transporter 2 inhibitors |
- In selected patients: Diuretics | Angiotensin receptor blockers | If-channel inhibitor | Combination of hydralazine and isosorbide dinitrate | Digoxin
Treatment of Heart failure with mildly reduced ejection fraction
Angiotensin-converting enzyme inhibitors | Angiotensin receptor II type 1 blockers | Beta-blockers | Mineralocorticoid receptor antagonists | Angiotensin receptor-neprilysin inhibitor | Other drugs | Devices
Treatment of Heart failure with preserved ejection fraction
Management of Acute heart failure
Oxygen therapy and/or ventilatory support Diuretics Vasodilators Inotropes Vasopressors Opiates Digoxin Thromboembolism prophylaxis Short-term mechanical circulatory support Pre-discharge assessment and post-discharge management planning
Managementof Advanced heart failure
Pharmacological therapy Renal replacement Mechanical circulatory support Heart transplantation Symptom control and end-of-life care
Secondary prevention
Nonpharmacological Interventions: Education Social Support Sodium Restriction: Recommendation Treatment of Sleep Disorders Weight Loss Activity, Exercise Prescription, and Cardiac Rehabilitation Patient education, self-care and lifestyle advice | Exercise rehabilitation | ==== Exercise Training ====
Follow-up of chronic heart failure Telemonitoring
- Acute Pharmacotherapy
- Chronic Pharmacotherapy in HFpEF
- Chronic Pharmacotherapy in HFrEF:
- Drugs to Avoid | Drug Interactions
Surgical Therapy:
- Biventricular Pacing or Cardiac Resynchronization Therapy (CRT) | Implantation of Intracardiac Defibrillator | Ultrafiltration | Left Ventricular Assist Devices (LVADs) | Cardiac Transplantation | Cardiac Surgery
ACC/AHA Guideline Recommendations
Hospitalized Patients
Patients With a Prior MI
Sudden Cardiac Death Prevention
Stage A: Patients at High Risk for Developing Heart Failure
Treatment of Hypertension | Treatment of Diabetes Mellitus | Management of Metabolic Syndrome | Management of Atherosclerotic Disease | Control of Conditions That May Cause Heart Failure | ACC/AHA Guideline Recommendations
Stage B: Patients with Cardiac Structural Abnormalities
Stage C: Patients with Current or Prior Heart Failure Symptoms
Stage D: Patients with Refractory End-stage Heart Failure
Implementation of Practice Guidelines
End-Of-Life Considerations
Specific Groups
Special Populations | Patients who have concomitant disorders | Obstructive Sleep Apnea in the Patient with CHF
Sources
- The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult [1]
- 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation [2]
References
- ↑ Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112 (12):e154-235. DOI:10.1161/CIRCULATIONAHA.105.167586 PMID: 16160202
- ↑ Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967