[Therapeutic strategy of acute and chronic heart failure].
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.
Momomura
S
S
Second Department of Internal Medicine, University of Tokyo.
Iizuka
M
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D004039:Diet, Sodium-Restricted; D004070:Digitalis; D004232:Diuretics / Q000627:therapeutic use; D005081:Exercise Therapy; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006440:Hemofiltration; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D010946:Plants, Medicinal; D010947:Plants, Toxic
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics