Management of heart failure

Heart failure is associated with high rates of morbidity and mortality. Because heart failure is difficult to diagnose accurately on the basis of the history and physical examination alone, It is vital that clinical evaluation such as echocardiography be used to confirm the diagnosis. In addition, it is important to identify etiologic or predisposing factors that may be reversible. Angiotensin-converting enzyme inhibitors should be considered in all patients with a diagnosis of left ventricular systolic dysfunction, unless contraindications exist. Diuretics and digoxin are helpful in specific circumstances. Comorbid factors such as excessive alcohol intake and coronary artery insufficiency should be addressed. Patient and family education and cooperation with medical regimens can reduce morbidity and mortality.