Related Experiment Video

Updated: Jun 20, 2026

Workflow and Framework for Collecting and Implementing Point-of-Care Ultrasound Data in the Management of Heart Failure Patients
03:47

Workflow and Framework for Collecting and Implementing Point-of-Care Ultrasound Data in the Management of Heart Failure Patients

Published on: July 12, 2024

Are the heart failure guidelines being implemented in primary care?

Samuel-Datum Moscavitch1, Juliana Lago Garcia, Lorraine Furlane Rosa

  • 1Center for Autoimmune Diseases and Department of Medicine B, Sheba Medical Center, Tel- Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Israel.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|August 25, 2009
PubMed

Insights

Primary care physicians in Brazil often deviate from heart failure management guidelines. Limited access to diagnostic tools like echocardiograms and recommended medications hinders optimal patient care.

Area of Science:

  • Cardiology
  • Public Health
  • Evidence-Based Medicine

Background:

  • Heart failure (HF) presents a significant public health challenge in Brazil due to its high prevalence.
  • Primary care management of HF is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the adherence of primary care physicians in Niterói, Rio de Janeiro, to Brazilian Society of Cardiology (BSC) guidelines for heart failure management.
  • To identify specific areas of divergence in clinical practice.

Main Methods:

  • A cross-sectional study involving 167 adult patients diagnosed with heart failure.
  • Data collection included questionnaires, physical exams, ECG, chest X-ray, and echocardiography (echo) as the gold standard.
  • Analysis compared physician practices against established BSC guidelines.

Main Results:

  • Echocardiography confirmed HF in only 66.5% of cases; 40.6% lacked prior diagnostic imaging.
  • Significant underuse of echo (11.4%), angiotensin-converting enzyme inhibitors (ACEIs) (64.1%), and beta-blockers (BBs) (26.0%) was observed.
  • Commonly prescribed BBs lacked proven mortality benefits; guideline-recommended drug combinations were underutilized.

Conclusions:

  • A notable gap exists between current primary care practices and BSC heart failure guidelines.
  • Limited availability of diagnostic tools (echo) and recommended medications, coupled with insufficient information, restricts optimal management.
  • Implementing continuous medical training programs is essential to improve guideline adherence and evidence-based practice in primary care.
Abstract

More Related Videos

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs14:35

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Published on: April 17, 2021

Related Concept Videos

Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...