Epidemiology, pathophysiology, prognosis, and treatment of systolic and diastolic heart failure.

摘要: Underlying causes, risk factors, and precipitating causes of heart failure (HF) should be treated. Drugs known to precipitate or aggravate HF such as nonsteroidal antiinflammatory drugs stopped. Patients with a low left ventricular ejection fraction (systolic failure) normal (diastolic HF) treated diuretics if fluid retention is present, an angiotensin-converting enzyme (ACE) inhibitor angiotensin receptor blocker the patient cannot tolerate ACE because cough, angioneurotic edema, rash, altered taste sensation, beta unless contraindicated. If severe systolic persists, aldosterone antagonist added. isosorbide dinitrate plus hydralazine Calcium channel blockers avoided present. Digoxin in men women diastolic sinus rhythm present HF. given symptoms persist, but serum digoxin level maintained between 0.5 0.8 ng/mL.