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afya
NICE2010HFMx
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> Trials showing improved mortality in chronic HF ACE inhibitors (SAVE, SOLVD, CONSENSUS) spironolactone (RALES) beta-blockers (CIBIS) hydralazine with nitrates (VHEFT-1) No long-term reduction in mortality for loop diuretics eg furosemide or digoxin key points ... 1st - ACE1 and BB 2nd - either aldosterone antagonist (esp if recent MI) or ARB (may cause angioedema) or Hydralazine with nitrate (intolerant to ACE/ARB or afro-caribbean) persistent Sx - cardiac resynchronisation or digoxin (inotropic effect may improve Sx esp if also AF) diuretics for fluid overload annual influenza vaccine one-off pneumococcal vaccine 5yrly if asplenia, splenic dysfunction or CKD)
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HeartFailure