Update in the approach to and management of heart failure

Jill Gelow, James C. Fang

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Heart failure (HF) is a prevalent and morbid chronic disease that patients experience in stages. Progression through the stages of HF can be slowed with optimal medical therapy. Although HF remains a clinical diagnosis made at the bedside, measurement of serum brain natriuretic peptide (BNP) can help in the diagnosis when there is uncertainty. The initial workup for patients with newly diagnosed HF is directed at identifying the underlying cause of left ventricular dysfunction. An assessment of hemodynamic status, determined by a careful physical examination, can be used to direct therapy.Angiotensin-converting enzyme inhibitors (ACEIs) and beta blockers remain the two most important therapies for patients with chronic HF. Aldosterone antagonists improve mortality but require close monitoring for severe hyperkalemia. Angiotensin-receptor blockers (ARBs) are excellent alternatives to ACEIs for ACEI-intolerant patients. Digoxin, a second line agent in HF, improves symptoms without mortality benefit. Successful management of HF requires aggressive management of comorbid conditions and careful follow up to slow disease progression, optimize functional status, and improve longevity.

Original languageEnglish (US)
Pages (from-to)1346-1355
Number of pages10
JournalSouthern Medical Journal
Volume99
Issue number12
DOIs
StatePublished - Dec 2006
Externally publishedYes

Fingerprint

Heart Failure
Angiotensin-Converting Enzyme Inhibitors
Mineralocorticoid Receptor Antagonists
Hyperkalemia
Mortality
Brain Natriuretic Peptide
Angiotensin Receptor Antagonists
Digoxin
Left Ventricular Dysfunction
Physical Examination
Uncertainty
Disease Progression
Chronic Disease
Therapeutics
Hemodynamics
Serum

Keywords

  • Aldosterone antagonists
  • Angiotensin-converting enzyme inhibitors
  • Angiotensin-receptor blockers
  • Beta blockers
  • Digoxin
  • Heart failure
  • Left ventricular dysfunction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Update in the approach to and management of heart failure. / Gelow, Jill; Fang, James C.

In: Southern Medical Journal, Vol. 99, No. 12, 12.2006, p. 1346-1355.

Research output: Contribution to journalArticle

Gelow, Jill ; Fang, James C. / Update in the approach to and management of heart failure. In: Southern Medical Journal. 2006 ; Vol. 99, No. 12. pp. 1346-1355.
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