title: [Optimal treatment of chronic heart failure--with particular emphasis on angiotensin-converting enzyme (ACE) inhibitors].
abstract: The article reviews recent discoveries about the pathophysiology of chronic heart failure, especially where new insights have led to new treatment strategies, with particular emphasis on the use of angiotensin converting enzyme inhibitors. Indications for referral of patients with chronic heart failure to hospital for further investigation or treatment are also given. It is concluded that ACE-inhibitors represent a new era in the treatment of chronic heart failure in patients with isolated or for the main part systolic left ventricle dysfunction, and that ACE-inhibitor treatment must be regarded as a first line drug in this condition, along with diuretics and perhaps digoxin. Patients in NYHA class IIIb-IV should be referred to a specialist or hospital with regard to supplemental cardiological investigations and initiation of ACE-inhibitor treatment, if such treatment has not already ben started. Patients with slight to moderate heart failure (NYHA class II-IIIa) should be referred as well, unless it is known that the cause of heart failure is an ischaemic heart condition that does not require operation. In the latter case, after the relevant investigations have been conducted, ACE-inhibitor treatment can usually be started in a general practice setting, bearing the usual safety regulations and contraindications in mind.
authors.affiliation: Odense Sygehus, kardiologisk afdeling B.
authors.forename: T
authors.initials: T
authors.lastname: Haghfelt
mesh_terms: D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002908:Chronic Disease; D000075202:Contraindications; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D014665:Vasodilator Agents; D004077:Digoxin
vernacular_title: Optimal behandling af kronisk hjerteinsufficiens--med speciel fokusering på angiotensinkoverterende enzym (ACE)-haemmerbehandling.