Epidemiology, pathophysiology, prognosis, and treatment of systolic and diastolic heart failure.

Abstract:

:Underlying causes, risk factors, and precipitating causes of heart failure (HF) should be treated. Drugs known to precipitate or aggravate HF such as nonsteroidal antiinflammatory drugs should be stopped. Patients with HF and a low left ventricular ejection fraction (systolic heart failure) or normal ejection fraction (diastolic HF) should be treated with diuretics if fluid retention is present, with an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker if the patient cannot tolerate an ACE inhibitor because of cough, angioneurotic edema, rash, or altered taste sensation, and with a beta blocker unless contraindicated. If severe systolic HF persists, an aldosterone antagonist should be added. If HF persists, isosorbide dinitrate plus hydralazine should be added. Calcium channel blockers should be avoided if systolic HF is present. Digoxin should be avoided in men and women with diastolic HF if sinus rhythm is present and in women with systolic HF. Digoxin should be given to men with systolic HF if symptoms persist, but the serum digoxin level should be maintained between 0.5 and 0.8 ng/mL.

journal_name

Cardiol Rev

journal_title

Cardiology in review

authors

Aronow WS

doi

10.1097/01.crd.0000175289.87583.e5

subject

Has Abstract

pub_date

2006-05-01 00:00:00

pages

108-24

issue

3

eissn

1061-5377

issn

1538-4683

pii

00045415-200605000-00002

journal_volume

14

pub_type

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