Feature Article

Investigation and management of chronic heart failure

Andrew Sindone



Chronic heart failure severely impairs patients’ quality of life and is a highly lethal disease. Although the outlook is bleak for many patients, medical therapy, specialist review and ongoing assessment can help control symptoms, reduce rehospitalisations and improve survival.

Key Points

  • Each year 30,000 Australians are newly diagnosed with CHF.
  • Approximately 50% of patients die within five years of being diagnosed with CHF.
  • CHF is a costly, debilitating disease and has a higher mortality than many cancers.
  • It is preferable that all patients who are suspected of having CHF are reviewed at least once by a cardiologist. Ongoing assessment is important for patients with CHF to maintain their quality of life.
  • Echocardiography is the gold standard for diagnosing CHF. Plasma B-type natriuretic peptide is emerging as a useful diagnostic adjunct.
  • ACE inhibitors, beta blockers and spironolactone have been shown to improve survival in CHF while diuretics improve symptoms and reduce hospitalisations.
  • A range of nonpharmacological interventions including exercise, patient support programs and cardiac devices play an important role in the management of CHF.