Heart Failure
STAGE C
Structural heart disease with
prior or current symptoms of HF
eg, Patients with:
•Known structural heart disease
and
•HF signs and symptoms
HFp EF
THERAPY
Goals
•Control symptoms
•Improve HRQOL
•Prevent
hospitalization
•Prevent mortality
Strategies
•Identification of
comorbidities
Treatment
•Diuresis to relieve
symptoms of
congestion
•Follow guidelinedriven indications
for comorbidities,
eg, hypertension,
AF, CAD, diabetes
mellitus
•Revascularization or
valvular surgery as
appropriate
STAGE D
Refractory HF
Refractory
symptoms of HF eg, Patients with:
at rest, despite
•Marked HF
GDMT
symptoms at rest
•Recurrent
hospitalizations
despite GDMT
HFr EF
THERAPY
Goals
•Control symptoms
•Patient education
•Prevent hospitalization
•Prevent mortality
Drugs for routine use
•Diuretics for fluid
retention
•ACEI or ARB
•Beta blockers
•Aldosterone antagonists
Drugs for use in selected
patients
•Hydralazine and
isosorbide dinitrate
•ACEI and ARB
•Digitalis
In selected patients
•CRT
•ICD
•Revascularization or
valvular surgery as
appropriate
THERAPY
Goals
•Control symptoms
•Improve HRQOL
•Reduce hospital
readmissions
•Establish patient's
end-of-life goals
Options
•Advanced care
measures
•Heart
transplantation
•Chronic inotropes
•Temporary or
permanent MCS
•Experimental
surgery or drugs
•Palliative care and
hospice
•ICD deactivation
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