Congestive heart failure AHA recommendations: Difference between revisions

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(/* Initial and Serial Evaluation of the HF Patient (DO NOT EDIT){{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE et al.| title=2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American C...)
(/* Initial and Serial Evaluation of the HF Patient (DO NOT EDIT){{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE et al.| title=2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American C...)
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.'''  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' In ambulatory patients with dyspnea, measurement of BNP or N-terminal pro-B-type natriuretic peptide (NT-proBNP) is useful to support clinical decision making regarding the diagnosis of HF,  especially in the setting of clinical uncertainty.<ref name="pmid16412859">{{cite journal| author=Costello-Boerrigter LC, Boerrigter G, Redfield MM, Rodeheffer RJ, Urban LH, Mahoney DW et al.| title=Amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide in the general community: determinants and detection of left ventricular dysfunction. | journal=J Am Coll Cardiol | year= 2006 | volume= 47 | issue= 2 | pages= 345-53 | pmid=16412859 | doi=10.1016/j.jacc.2005.09.025 | pmc=PMC2647136 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16412859  }} </ref><ref name="pmid12215132">{{cite journal| author=Vasan RS, Benjamin EJ, Larson MG, Leip EP, Wang TJ, Wilson PW et al.| title=Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: the Framingham heart study. | journal=JAMA | year= 2002 | volume= 288 | issue= 10 | pages= 1252-9 | pmid=12215132 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12215132 }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>


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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Screening for hemochromatosis or HIV is reasonable in selected patients who present with [[HF]].<ref name="pmid21903058">{{cite journal| author=Okonko DO, Mandal AK, Missouris CG, Poole-Wilson PA| title=Disordered iron homeostasis in chronic heart failure: prevalence, predictors, and relation to anemia, exercise capacity, and survival. | journal=J Am Coll Cardiol | year= 2011 | volume= 58 | issue= 12 | pages= 1241-51 | pmid=21903058 | doi=10.1016/j.jacc.2011.04.040 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21903058  }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>


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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' Diagnostic tests for rheumatologic diseases, amyloidosis, or pheochromocytoma are reasonable inpatients presenting with HF in whom there is a clinical suspicion of these diseases.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>


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Revision as of 17:10, 10 August 2013
Resident
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ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
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Coordinating Care for Patients With Chronic HF
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Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

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Risk calculators and risk factors for Congestive heart failure AHA recommendations

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2013 ACCF/AHA Guideline/2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Heart Failure in the Adult (DO NOT EDIT) [1][2]

Initial and Serial Evaluation of the HF Patient (DO NOT EDIT)[1]

Class I
"1. A thorough history and physical examination should be obtained/performed in patients presenting with HF to identify cardiac and noncardiac disorders or behaviors that might cause or accelerate the development or progression of HF. (Level of Evidence: C) "
"2. In patients with idiopathic DCM, a 3-generational family history should be obtained to aid in establishing the diagnosis of familial DCM. (Level of Evidence: C ) "
"3. Volume status and vital signs should be assessed at each patient encounter. This includes serial assessment of weight, as well as estimates of jugular venous pressure and the presence of peripheral edema or orthopnea.[3][4] (Level of Evidence: B ) "
"4. Initial laboratory evaluation of patients presenting with HF should include complete blood count, urinalysis, serum electrolytes (including calcium and magnesium), blood urea nitrogen, serum creatinine, glucose, fasting lipid profile, liver function tests, and thyroid-stimulating hormone. Serial monitoring, when indicated, should include serum electrolytes and renal function. A 12-lead ECG should be performed initially on all patients presenting with HF. (Level of Evidence: C) "
"5. In ambulatory patients with dyspnea, measurement of BNP or N-terminal pro-B-type natriuretic peptide (NT-proBNP) is useful to support clinical decision making regarding the diagnosis of HF, especially in the setting of clinical uncertainty.[5][6](Level of Evidence: A) "
"6. (Level of Evidence: ) "
"7. (Level of Evidence: ) "
"8. (Level of Evidence: ) "
"9. (Level of Evidence: ) "
"10. (Level of Evidence: ) "
Class III (No Benefit)


"1. (Level of Evidence: ) "


"2. (Level of Evidence: ) "
Class IIa
"1. Validated multivariable risk scores can be useful to estimate subsequent risk of mortality in ambulatory or hospitalized patients with HF.[7][8] (Level of Evidence: B) "
"2. Screening for hemochromatosis or HIV is reasonable in selected patients who present with HF.[9](Level of Evidence: C) "
"3. Diagnostic tests for rheumatologic diseases, amyloidosis, or pheochromocytoma are reasonable inpatients presenting with HF in whom there is a clinical suspicion of these diseases.(Level of Evidence: C) "
"4. (Level of Evidence: ) "
"5. (Level of Evidence: ) "


"6. (Level of Evidence: ) "
Class IIb
"1. (Level of Evidence: ) "
"2. (Level of Evidence: ) "
"3. (Level of Evidence: ) "
"4. (Level of Evidence: ) "
"5. (Level of Evidence: ) "
"6. (Level of Evidence: ) "
"7. (Level of Evidence: ) "

Vote on and Suggest Revisions to the Current Guidelines


External Links

References

  1. ↑ 1.0 1.1 1.2 Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE; et al. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
  2. ↑ 2.0 2.1 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
  3. ↑ Butman SM, Ewy GA, Standen JR, Kern KB, Hahn E (1993). "Bedside cardiovascular examination in patients with severe chronic heart failure: importance of rest or inducible jugular venous distension". J Am Coll Cardiol. 22 (4): 968–74. PMID 8409071.
  4. ↑ Stevenson LW, Perloff JK (1989). "The limited reliability of physical signs for estimating hemodynamics in chronic heart failure". JAMA. 261 (6): 884–8. PMID 2913385.
  5. ↑ Costello-Boerrigter LC, Boerrigter G, Redfield MM, Rodeheffer RJ, Urban LH, Mahoney DW; et al. (2006). "Amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide in the general community: determinants and detection of left ventricular dysfunction". J Am Coll Cardiol. 47 (2): 345–53. doi:10.1016/j.jacc.2005.09.025. PMC 2647136. PMID 16412859.
  6. ↑ Vasan RS, Benjamin EJ, Larson MG, Leip EP, Wang TJ, Wilson PW; et al. (2002). "Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: the Framingham heart study". JAMA. 288 (10): 1252–9. PMID 12215132.
  7. ↑ Aaronson KD, Schwartz JS, Chen TM, Wong KL, Goin JE, Mancini DM (1997). "Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation". Circulation. 95 (12): 2660–7. PMID 9193435.
  8. ↑ Wedel H, McMurray JJ, Lindberg M, Wikstrand J, Cleland JG, Cornel JH; et al. (2009). "Predictors of fatal and non-fatal outcomes in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA): incremental value of apolipoprotein A-1, high-sensitivity C-reactive peptide and N-terminal pro B-type natriuretic peptide". Eur J Heart Fail. 11 (3): 281–91. doi:10.1093/eurjhf/hfn046. PMC 2645061. PMID 19168876.
  9. ↑ Okonko DO, Mandal AK, Missouris CG, Poole-Wilson PA (2011). "Disordered iron homeostasis in chronic heart failure: prevalence, predictors, and relation to anemia, exercise capacity, and survival". J Am Coll Cardiol. 58 (12): 1241–51. doi:10.1016/j.jacc.2011.04.040. PMID 21903058.
  10. ↑ 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.105.167586PMID: 16160202

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