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Treatment of Heart Failure

Treatment of Heart Failure. If symptoms are severe, refer to specialist: acute cases to emergency room, chronic cases to HF clinic If patient has HF symptoms but LVEF>40%, treat cause (e.g. hypertension, ischemia) If patient has systolic HF and LVEF <40%.

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Treatment of Heart Failure

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  1. Treatment of Heart Failure If symptoms are severe, refer to specialist: acute cases to emergency room, chronic cases to HF clinic If patient has HF symptoms but LVEF>40%, treat cause (e.g. hypertension, ischemia) If patient has systolic HF and LVEF <40% • For all symptomatic patients with systolic HF: • Education • Aggressive risk factor reduction • Lifestyle modifications • Salt/fluid vigilance • Tailored diuretic treatment Prescribe ARB ACE inhibitor + Beta blocker Prescribe ARB Consider nitrate/hydrazaline Intolerance Intolerance Intolerance Titrate to target doses Digoxin with/without nitrates Add ARB Combination diuretics Spironolactone Continue treatment NYHA Class IIIb-IV NYHA Class III Clinically stable If refractory, Consider transplant If LVEF <30%, consider ICD referral If QRS >120 ms, Consider CRT referral Persistent symptoms Adapted from: Arnold et al. Can J Cardiol January 2006;22(1):23-45.

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