The management of congestive heart failure

The symptoms and physical findings of congestive heart failure are learned during the early stages of medical education. They are considered prominently in physical diagnosis courses even before a medical student's clinical clerkships begin. Yet, the diagnosis and proper management of congestive heart failure may still represent a challenge even for the most experienced clinician. Obviously, there is more to this syndrome than a collection of symptoms and signs. In fact, it is probably best to reject entirely the concept of congestive heart failure as a syndrome and consider it merely a descriptive term that requires an application of knowledge and skills learned in physiology, pharmacology and clinical medicine if the patient is to receive proper care. Many fine monographs and textbooks have been written about congestive heart failure, from the standpoint of myocardial mechanics, pathophysiology, cardiovascular pharmacology and biochemistry. It is our aim in this monograph to provide clinical insights into the management of congestive heart failure, including such factors as myocardial mechanics and cardiovascular pharmacology only when applicable in a clinical sense. Several cases recently encountered are included to underscore certain concepts.