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...)
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''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. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''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]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>


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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' In patients with idiopathic DCM, a 3-generational family history should be obtained to aid in establishing the diagnosis of familial DCM. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C ]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' In patients with idiopathic [[DCM]], a 3-generational family history should be obtained to aid in establishing the diagnosis of familial [[DCM]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C ]])'' <nowiki>"</nowiki>


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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''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.<ref name="pmid8409071">{{cite journal| author=Butman SM, Ewy GA, Standen JR, Kern KB, Hahn E| title=Bedside cardiovascular examination in patients with severe chronic heart failure: importance of rest or inducible jugular venous distension. | journal=J Am Coll Cardiol | year= 1993 | volume= 22 | issue= 4 | pages= 968-74 | pmid=8409071 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8409071  }} </ref><ref name="pmid2913385">{{cite journal| author=Stevenson LW, Perloff JK| title=The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. | journal=JAMA | year= 1989 | volume= 261 | issue= 6 | pages= 884-8 | pmid=2913385 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2913385  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B ]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''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]].<ref name="pmid8409071">{{cite journal| author=Butman SM, Ewy GA, Standen JR, Kern KB, Hahn E| title=Bedside cardiovascular examination in patients with severe chronic heart failure: importance of rest or inducible jugular venous distension. | journal=J Am Coll Cardiol | year= 1993 | volume= 22 | issue= 4 | pages= 968-74 | pmid=8409071 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8409071  }} </ref><ref name="pmid2913385">{{cite journal| author=Stevenson LW, Perloff JK| title=The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. | journal=JAMA | year= 1989 | volume= 261 | issue= 6 | pages= 884-8 | pmid=2913385 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2913385  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B ]])'' <nowiki>"</nowiki>


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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1. '''Validated multivariable risk scores can be useful to estimate subsequent risk of mortality in ambulatory or hospitalized patients with HF.<ref name="pmid9193435">{{cite journal| author=Aaronson KD, Schwartz JS, Chen TM, Wong KL, Goin JE, Mancini DM| title=Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. | journal=Circulation | year= 1997 | volume= 95 | issue= 12 | pages= 2660-7 | pmid=9193435 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9193435  }} </ref><ref name="pmid19168876">{{cite journal| author=Wedel H, McMurray JJ, Lindberg M, Wikstrand J, Cleland JG, Cornel JH et al.| title=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. | journal=Eur J Heart Fail | year= 2009 | volume= 11 | issue= 3 | pages= 281-91 | pmid=19168876 | doi=10.1093/eurjhf/hfn046 | pmc=PMC2645061 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19168876  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1. '''Validated multivariable risk scores can be useful to estimate subsequent risk of mortality in ambulatory or hospitalized patients with [[HF]].<ref name="pmid9193435">{{cite journal| author=Aaronson KD, Schwartz JS, Chen TM, Wong KL, Goin JE, Mancini DM| title=Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. | journal=Circulation | year= 1997 | volume= 95 | issue= 12 | pages= 2660-7 | pmid=9193435 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9193435  }} </ref><ref name="pmid19168876">{{cite journal| author=Wedel H, McMurray JJ, Lindberg M, Wikstrand J, Cleland JG, Cornel JH et al.| title=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. | journal=Eur J Heart Fail | year= 2009 | volume= 11 | issue= 3 | pages= 281-91 | pmid=19168876 | doi=10.1093/eurjhf/hfn046 | pmc=PMC2645061 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19168876  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>


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Revision as of 15:45, 10 August 2013



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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)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure AHA recommendations On the Web

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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. (Level of Evidence: ) "
"5. (Level of Evidence: ) "
"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.[5][6] (Level of Evidence: B) "
"2. (Level of Evidence: ) "
"3. (Level of Evidence: ) "
"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. 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.
  6. 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.
  7. 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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