Feature Article

Chronic heart failure. Part 2: treatment and prevention

Kiran Swaraj, Peter MacDonald
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The currently available pharmacological therapies and surgical interventions for chronic heart failure can have a major impact on patient survival and quality of life. Despite this, the overall prognosis of patients with this condition remains poor.

Key Points

  • ACE inhibitors are indicated for all patients with systolic heart failure regardless of symptomatic severity.
  • Beta blockers are approved for use in patients who have stable chronic symptomatic heart failure despite ACE inhibitor and diuretic treatment.
  • Diuretics should be used in all patients with symptomatic heart failure to control symptoms and signs of congestion.
  • Nonpharmacological approaches to CHF management include sodium and fluid restriction, exercise for patients with stable CHF and patient support.
  • A multidisciplinary approach to CHF management markedly improves patient quality of life, reduces the need for hospitalisation and is cost effective.
  • The most effective therapy available for heart failure is heart transplantation; its use is limited by donor organ availability.
  • Despite the therapeutic options available, the overall prognosis of patients with CHF remains poor.