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Editorial
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Volume 341:752-755 September 2, 1999 Number 10
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Aldosterone and Spironolactone in Heart Failure

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Chronic heart failure occurs most commonly after earlier myocardial infarction or in the presence of long-standing hypertension. The inability of this normally efficient muscular pump to eject or receive blood results in characteristic symptoms and signs. In patients with compensated heart failure, breathlessness and fatigue occur only with moderate or greater levels of exertion, and physical signs of increased plasma and extravascular volumes are absent. Symptoms that occur with minimal exertion or at rest, accompanied by jugular venous distention and edema of the lower extremities, reflect decompensation. Congestive heart failure, a syndrome arising from hypoperfused tissues and congested organs, has . . . [Full Text of this Article]

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