[Summary of the practice guideline 'Heart failure' (first revision) from the Dutch College of General Practitioners].
The guideline entitled 'Heart failure' from the Dutch College of General Practitioners has been revised. The general practitioner makes the diagnosis of heart failure in a patient with the core symptoms (dyspnoea, fatigue, oedema) in combination with paroxysmal nocturnal dyspnoea, orthopnoea, crepitations, elevated central-venous pressure, a third heart sound or ifictus cordis is visible outside the mid-clavicular line. Further investigations include a panel of laboratory investigations, an ECG and possibly echocardiography and radiographic chest investigations. One new recommendation is that on suspicion of heart failure the plasma concentrations of B-type natriuretic peptide (BNP) or N-terminal pro-BNP should be investigated. The step-by-step medication plan has been changed; beta-blockers have been introduced to the plan. In the treatment of acute heart failure, rapidly working sublingual nitrates should be given first and foremost.
van Lieshout
J
J
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Postbus 3231, 3502 GE Utrecht.
Rutten
F H
FH
Walma
E P
EP
Wiersma
T
T
Goudswaard
A N
AN
D004562:Electrocardiography; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010821:Physicians, Family / Q000592:standards*; D010818:Practice Patterns, Physicians'; D012955:Societies, Medical
D020097:Natriuretic Peptide, Brain