Chronic congestive heart failure. Eight steps in management

Management of chronic heart failure should include clinical evaluation to confirm the diagnosis and to search for treatable causes, bed rest to reduce work of the heart, digitalis therapy to improve myocardial contractility and/or rate control with atrial fibrillation, and restriction of sodium intake and administration of diuretics to reduce congestion. Vasodilators may be helpful, and anticoagulation is recommended to prevent thromboembolism. In highly selected patients with refractory heart failure, cardiac transplantation may be considered.