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Previous Volume 335:490-498 August 15, 1996 Number 7 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Heart failure is a complex of symptoms — fatigue, shortness of breath, and congestion — that are related to the inadequate perfusion of tissue during exertion and often to the retention of fluid. Its primary cause is an impairment of the heart's ability to fill or empty the left ventricle properly.

The management of heart failure can no longer be confined to the relief of symptoms. The processes that contribute to left ventricular dysfunction may progress independently from the development of symptoms (Figure 1). Treatment to prevent or delay the progression of left ventricular dysfunction may therefore be . . . [Full Text of this Article]

The Mechanisms and Diagnosis of Left Ventricular Dysfunction

The Mechanisms and Diagnosis of Heart Failure

Goals of Therapy

Relief of Symptoms

Nonpharmacologic Management

Drug Therapy

            Diuretics

            Vasodilators

            Digoxin

Prolonging the Lives of Patients with Left Ventricular Dysfunction

Nonpharmacologic Management

Drug Therapy

            ACE Inhibitors

            Hydralazine and Isosorbide Dinitrate

            Antiarrhythmic Drugs

            Anticoagulant Therapy

Common Errors in the Management of Heart Failure

Not Recognizing Heart Failure

Improper Dosage of Diuretics

Failure to Assess the Quality of Life

Failure to Consider Long-Term Therapeutic Goals

Inadequate Dosage of ACE Inhibitors

Failure to Use Hydralazine and Isosorbide Dinitrate

Use of Potentially Harmful Drugs

New Approaches to Management

Beta-Adrenergic Antagonists

Beta-Adrenergic Antagonists with Vasodilative Action

Vesnarinone

Calcium Antagonists

Neurohormonal Inhibitors

Other Drugs with Cardiac Action

Optimal Management

Source Information

From the Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Box 508 UMHC, 420 Delaware St. S.E., Minneapolis, MN 55455, where reprint requests should be addressed to Dr. Cohn.

References

Related Letters:

The Management of Chronic Heart Failure
Howard P. A., Dunn M. I., Sahebjami H., Cohn J. N.
Extract | Full Text  
N Engl J Med 1997; 336:295-296, Jan 23, 1997. Correspondence

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