BMJ 1994;308:321-328 (29 January)

Education and debate

Fortnightly Review: Diagnosis and management of heart failure

H J Dargie, J J V McMurray 

Department of Cardiology, Western Infirmary, Glasgow G11 6NT Cardiac Department, Western General Hospital, Edinburgh EH4 2XU.


Summary points

  • Summary points

  • Heart failure is a malignant condition with high rates of morbidity and mortality even in so called mild cases

  • Left ventricular dysfunction is the main cause of heart failure, and echocardiography can quickly distinguish less common but reversible causes

  • The most effective medical treatments for heart failure are diuretics, usually a loop diuretic, and angiotensin converting enzyme inhibitors

  • If patients remain symptomatic or cannot tolerate angiotensin converting enzyme inhibitors, other treatments such as hydralazine and isosorbide dinitrate or digoxin may be used, and as a last resort cardiac transplantation may be considered

  • Concomitant problems that may need treatment are atrial fibrillation, angina, and ventricular arrhythmia


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Relevant Article

Palliative care in severe heart failure
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BMJ 1994 308: 717. [Extract] [Full Text]

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