[Pharma-clinics. How I treat...symptomatic heart failure].
Restriction of physical activities (which does not exclude participation in tailored rehabilitation programmes), limitation of water and sodium intake, diuretics and digitalis (at least in the presence of atrial fibrillation) have long been used in the therapy of symptomatic congestive heart failure. Nowadays, the value of inhibiting the sympathetic and renin-angiotensin-aldosterone response to cardiac output lowering is well established; ideally, this requires concomitant administration of an ACE-inhibitor, a beta-blocker and spironolactone. All treatable causes of myocardial dysfunction should be adequately corrected (including chronic myocardial ischemia). When needed, patients should also be protected against lethal ventricular arrhythmias, and thrombo-embolic complications.
Kulbertus
H
H
Service de Cardiologie, Université de Liège.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy; D003657:Decision Making; D004232:Diuretics / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D012084:Renin-Angiotensin System / Q000502:physiology; D013148:Spironolactone / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D013148:Spironolactone