Fast Five Quiz: Test Your Knowledge on Key Aspects of Heart Failure

Yasmine S. Ali, MD, MSCI

Disclosures

December 22, 2021

Nitrates are potent venodilators. These agents decrease preload and therefore decrease LV filling pressure and relieve dyspnea. They also selectively produce epicardial coronary artery vasodilatation and help with myocardial ischemia. Although nitrates can be used in different forms (sublingual, oral, transdermal, intravenous), the most common route of administration in acute HF is intravenous. Use of nitrates is limited by tachyphylaxis and headache.

Patients with HF can benefit from attention to exercise, diet, and nutrition. Restriction of activity promotes physical deconditioning, so physical activity should be encouraged. However, limitation of activity is appropriate during acute HF exacerbations and in patients with suspected myocarditis. Most patients should not participate in heavy labor or exhaustive sports.

A combination of 3 types of drugs (a diuretic, an ACEI or an ARB, and a beta-blocker) is recommended in the routine management of most patients with HF. ACEIs/ARBs and beta-blockers are generally used together. Beta-blockers are started in the hospital once euvolemic status has been achieved.

Because of the possibility of ventricular recovery and lengthened patient survival, most patients with HF and aortic stenosis are offered valve replacement.

For additional information, refer to the following clinical practice guidelines:

  • 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines

  • 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America

  • 2021 European Society of Cardiology (ESC) Acute and Chronic Heart Failure Guidelines

Learn more about the treatment of HF.

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