[Therapy of chronic heart failure].
Symptoms of chronic cardiac failure depend on four determinants: The initial event concerns a decrease in contractility. The resulting complex neurohumoral regulatory mechanisms are essentially sympathicomimetic and stimulate the renin-angiotensin system. Accordingly, pre- and afterload will increase and symptoms may become aggravated by dys- or arrhythmias. Symptomatic pharmacotherapy of cardiac failure is directed to these four determinants. The actual rationale for its use is presented, putting emphasis on the renewed controversy on digitalis and on the importance of vasodilators, in particular ACE inhibitors. The relevance of diagnostic evaluation before and during treatment is indicated. The adaptation of treatment according to different causative disorders leading to cardiac failure is outlined. Finally, open questions and unsolved problems are brought up.
Nager
F
F
Medizinische Klinik, Kantonsspital Luzern.
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D004071:Digitalis Glycosides / Q000009:adverse effects / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D014665:Vasodilator Agents / Q000627:therapeutic use
D000806:Angiotensin-Converting Enzyme Inhibitors; D002317:Cardiovascular Agents; D004071:Digitalis Glycosides; D004232:Diuretics; D014665:Vasodilator Agents
Therapie der chronischen Herzinsuffizienz.