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[Therapeutic strategy of acute and chronic heart failure]
1Second Department of Internal Medicine, University of Tokyo.
Insights
Effective heart failure management focuses on improving cardiac function and symptoms for better quality of life and survival. Diagnosis and treatment of underlying causes, alongside pharmacotherapy and special measures, are key strategies.
Area of Science:
- Cardiology
- Internal Medicine
Context:
- Heart failure (HF) management aims for immediate symptom relief and improved cardiac function.
- Long-term goals include enhancing patient quality of life and survival rates.
Purpose:
- To outline general approaches for effective heart failure management.
- To detail diagnostic and therapeutic strategies for heart failure.
Summary:
- Comprehensive patient evaluation and diagnosis of underlying causes are crucial.
- Therapeutic measures include pharmacotherapy (digoxin, diuretics, vasodilators), inotropic drugs for refractory cases, and consideration of dialysis or assisted circulation.
- Management of ventricular arrhythmias in heart failure patients remains a complex and debated topic.
Impact:
- Provides a foundational understanding of heart failure treatment strategies.
- Highlights the importance of personalized management based on HF type and severity.
- Informs clinical practice regarding pharmacotherapy and advanced interventions for heart failure.
Abstract:
The immediate goal of management of heart failure is to improve cardiac function and eliminate symptoms. On the other hand, the final goal is to improve the quality of life and survival. In this chapter, general approaches to fulfill these goals are discussed. First, precise evaluation of the patient is necessary and the underlying cause of heart failure must be diagnosed. If possible, the underlying cause should be rectified. Precipitating factors, such as infection, should also be removed. Appropriate therapeutic measures are then selected according to the type and severity of heart failure. In pharmacotherapy, digoxin, diuretics and vasodilators are usually used in combination. In refractory heart failure, inotropic drugs, including sympatomimetic amines, are usually effective. Special measures including dialysis and assisted circulation, may also be considered in acute or refractory heart failure. Finally, management of ventricular arrhythmias in patients with heart failure is still controversial.