TX of HF

HF TX (general)

• Tx underlying DZ (CAD, HTN, DM, valvular dz, cardiomyopathy, thyroid)

• Lifestyle modification with daily weight monitoring (5lb weight ↑ ➔ double diuretic dose)

  • Quit smoking and etOH, avoid NSAIDs

  • Na restrict to <3g/day

• Everyone gets β-blocker and ACEi or ARB (only carvedilol, bisoprolol, metoprolol are indicated in HF)

• Ischemic/CAD: add on ASA and statin

• Class II (activity/exercise ➔ SSX): probably due to fluid ➔ loop diuretics

• CLASS III (comfortable only at rest): spironolactone, hydralazine/isosorbide dinitrate (BiDil)

• EF <35%: AICD (Automated Internal Cardioverter/Defibrilator), NYHA 2 or 3 that don't respond to meds

• Class IV: milrinone or dobutamine (while waiting for LVAD/transplant)