Managing heart failure: update from Michael Reese's special program

Heart failure is a major health problem, particularly among the elderly who experience the long term consequence of coronary artery disease. Over the past several years, the heart failure program at Michael Reese Hospital has seen a large number of elderly patients with heart failure. Two-thirds of these patients had a previous myocardial infarction, while 20% had an idiopathic (dilated) cardiomyopathy. Herein, we review that experience, focusing particularly on clinical presentation, our non-invasive approach to objectively determining their functional capacity and the severity of their failure, and, finally, a consideration of the various aspects of their medical management.