Diagnostic and therapeutic algorithms in chronic heart failure

The Treatment of chronic heart failure (CHF) has improved markedly over the last 10-15 years. Mortality and morbidity have been reduced significantly. However, CHF is still associated with a high mortality and is costly due to the need for hospitalization of many patients. The best management of patients with CHF includes correct diagnosis and risk assessment, symptomatic treatment of fluid retention, if present, and a combination of at least two neurohormonal antagonists to improve prognosis. Optimal practice in most organizations needs a structured approach to the management. In order to achieve this optimal management, guidelines are used to harmonize and encourage implementation of treatments. Guidelines from Europe and North America are harmonized as they are based on the same evidence. However, in some important aspects there can be differences in the interpretation of the evidence. A comparison of four major guideline documents was published recently.