wikidoc - Changes related to "Category:Emergency medicine" [en]

Hypertensive crisis

2026-05-11T19:46:32Z

The terminology has been updated from Hypertensive urgency to severe hypertension; the treatment section has been extensively updated in line with the 2025 AHA/ACC HTN Guidelines.

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Congestive heart failure pharmacotherapy

2026-05-10T17:14:19Z

Overview

← Older revision		Revision as of 17:14, 10 May 2026
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	== Overview ==		== Overview ==
			Management of heart failure is guided by [[ejection fraction]] phenotype ([[HFrEF]] vs HFmrEF/[[HFpEF]]), clinical stage, congestion status, and underlying etiology, with the goals of improving symptoms, reducing hospitalization, and improving survival. Contemporary care prioritizes rapid initiation and optimization of GDMT (foundational 4-drug therapy in [[HFrEF]]; SGLT2 inhibitor–centered, comorbidity-driven therapy with selective ARNI/[[ARB]]/MRA in HFmrEF/[[HFpEF]]) alongside diuretics for relief of congestion. Longitudinal management requires structured reassessment of symptoms, vitals, renal function/electrolytes, and cardiac function to guide titration, add-on therapies, and candidacy for [[Implantable cardioverter defibrillator\|ICD]]/[[Cardiac resynchronization therapy\|CRT]] or structural interventions, with referral for advanced HF therapies when progression occurs. Effective implementation is strengthened by multidisciplinary HF programs, patient education and lifestyle interventions, and coordinated transitions of care.

	== Management of [[patients]] with heart failure with reduced ejection fraction ([[HFrEF]])==		== Management of [[patients]] with heart failure with reduced ejection fraction ([[HFrEF]])==

Congestive heart failure with preserved EF pharmacotherapy

2026-05-10T16:38:28Z

← Older revision		Revision as of 16:38, 10 May 2026
(2 intermediate revisions by the same user not shown)
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	\| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center \|'''Recommedation for patients with NYHA class 2-4 heart failure with mildly reduced ejection fraction		\| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center \|'''Recommedation for patients with NYHA class 2-4 heart failure with mildly reduced ejection fraction
	\|-		\|-
	\|style="font-size: 100; padding: 0 5px; background: #~~B8B8B8~~" align=left \|''' [[Diuretics]] ([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''		\|style="font-size: 100; padding: 0 5px; background: #EDFAED" align=left \|''' [[Diuretics]] ([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''
	\|-		\|-
	\|style="padding: 0 5px; font-size: 100%; background: ~~#F5F5F5~~; width: 70%" align=left\|		\|style="padding: 0 5px; font-size: 100%; background: LightGreen; width: 70%" align=left\|
	❑ [[Diuretics]] are recommended in [[patients]] with [[congestion]] and [[HFmrEF]] in order reduce [[symptoms]] and [[signs]]<br>		❑ [[Diuretics]] are recommended in [[patients]] with [[congestion]] and [[HFmrEF]] in order reduce [[symptoms]] and [[signs]]<br>
	\|-		\|-
	\|style="font-size: 100; padding: 0 5px; background: #~~B8B8B8~~" align=left \|''' [[ACEI]] ([[ESC guidelines classification scheme\|Class IIb, Level of Evidence C]]):'''		\|style="font-size: 100; padding: 0 5px; background: #EDFAED" align=left \|''' [[ACEI]] ([[ESC guidelines classification scheme\|Class IIb, Level of Evidence C]]):'''
	\|-		\|-
	\|style="padding: 0 5px; font-size: 100%; background: ~~#F5F5F5~~; width: 70%" align=left\|		\|style="padding: 0 5px; font-size: 100%; background: LemonChiffon; width: 70%" align=left\|
	❑ [[ACE-I]] may be considered for patients with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>		❑ [[ACE-I]] may be considered for patients with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>
	❑ [[ARB]] may be indicated for [[patients]] with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>		❑ [[ARB]] may be indicated for [[patients]] with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>
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	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2021 ESC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 ESC Guideline</small>''<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>
	\|-		\|-
	\|}<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>		\|}


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	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2022 AHA Guideline</small>''<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}

	==[[Heart failure]] With Improved [[Ejection Fraction]] ([[HFimpEF]])==		==[[Heart failure]] With Improved [[Ejection Fraction]] ([[HFimpEF]])==
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	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above tables adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above tables is adopted from 2022 AHA Guideline</small>''
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
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	{{familytree/end}}		{{familytree/end}}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above tables adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above tables is adopted from 2022 AHA Guideline</small>''<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}


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	\|-		\|-
	\|style="font-size: 100; padding: 0 5px; background: #~~B8B8B8~~" align=left \|'''([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''		\|style="font-size: 100; padding: 0 5px; background: #EDFAED" align=left \|'''([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''
	\|-		\|-
	\|style="padding: 0 5px; font-size: 100%; background: ~~#F5F5F5~~; width: 70%" align=left\|		\|style="padding: 0 5px; font-size: 100%; background: LightGreen; width: 70%" align=left\|
	❑ Screening, treatment, investigation of underlying etiologies, and		❑ Screening, treatment, investigation of underlying etiologies, and
	[[cardiovascular]] and non-[[cardiovascular]] comorbidities is recommended in [[patients]] with [[HFpEF]]<br>		[[cardiovascular]] and non-[[cardiovascular]] comorbidities is recommended in [[patients]] with [[HFpEF]]<br>
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	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2021 ESC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 ESC Guideline</small>''<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>
	\|-		\|-
	\|}<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>		\|}


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	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above tables adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above tables is adopted from 2022 AHA Guideline</small>''<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}

	==External Link==		==External Link==

Congestive heart failure chronic pharmacotherapy

2026-05-10T16:24:34Z

Show changes

Congestive heart failure pharmacotherapy

2026-05-10T06:57:07Z

← Older revision		Revision as of 06:57, 10 May 2026
(One intermediate revision by the same user not shown)
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	<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]''		<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]''
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''<ref name="pmid35363499">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e895–e1032 \|date=May 2022 \|pmid=35363499 \|doi=10.1161/CIR.0000000000001063 \|url=}}</ref>
	\|-		\|-
	\|}		\|}
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	<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''		<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2021 AHA/ACC Guideline</small>''		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2021 AHA/ACC Guideline</small>''<ref name="pmid33446410">{{cite journal \|vauthors=Maddox TM, Januzzi JL, Allen LA, Breathett K, Butler J, Davis LL, Fonarow GC, Ibrahim NE, Lindenfeld J, Masoudi FA, Motiwala SR, Oliveros E, Patterson JH, Walsh MN, Wasserman A, Yancy CW, Youmans QR \|title=2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee \|journal=J Am Coll Cardiol \|volume=77 \|issue=6 \|pages=772–810 \|date=February 2021 \|pmid=33446410 \|doi=10.1016/j.jacc.2020.11.022 \|url=}}</ref>
	\|-		\|-
	\|}		\|}
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	<span style="font-size:85%">'''''ARNi:''' [[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''		<span style="font-size:85%">'''''ARNi:''' [[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''<ref name="pmid35363499"></ref>
	\|-		\|-
	\|}		\|}

	==Congestive heart failure treatment summary based on 2021 AHA/ACC Guideline<ref name="~~pmid33755495~~">{{cite journal \|vauthors=Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS \|title=2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure) \|journal=Circ Cardiovasc Qual Outcomes \|volume=14 \|issue=4 \|pages=e000102 \|date=April 2021 \|pmid=33755495 \|pmc=8059763 \|doi=10.1161/HCQ.0000000000000102 \|url=}}</ref>==		==Congestive heart failure treatment summary based on 2021 AHA/ACC Guideline<ref name="pmid33446410"></ref>==
	{\| border="1" cellpadding="2"		{\| border="1" cellpadding="2"
	!width="50"\|Pathophysiology		!width="50"\|Pathophysiology
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	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 AHA/ACC Guideline</small>''		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 AHA/ACC Guideline</small>''<ref name="pmid33446410"></ref>
	\|-		\|-
	\|}		\|}
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	{{clear}}		{{clear}}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table adopted from 2021 AHA/ACC Guideline</small>''<ref name="~~pmid33755495~~">{{cite journal \|vauthors=Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS \|title=2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure) \|journal=Circ Cardiovasc Qual Outcomes \|volume=14 \|issue=4 \|pages=e000102 \|date=April 2021 \|pmid=33755495 \|pmc=8059763 \|doi=10.1161/HCQ.0000000000000102 \|url=}}</ref>		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table adopted from 2021 AHA/ACC Guideline</small>''<ref name="pmid33446410"></ref>

	\|-		\|-

Sandbox

2026-05-10T06:45:55Z

← Older revision	Revision as of 06:45, 10 May 2026
(One intermediate revision by the same user not shown)
(No difference)

Congestive heart failure pharmacotherapy

2026-05-10T06:24:48Z

Show changes

Sandbox

2026-05-10T06:01:19Z

← Older revision		Revision as of 06:01, 10 May 2026
(4 intermediate revisions by the same user not shown)
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	== Management of [[patients]] with [[heart failure reduced ejection fraction\|heart failure with reduced ejection fraction]] ([[HFrEF]])==		== Management of [[patients]] with [[heart failure reduced ejection fraction\|heart failure with reduced ejection fraction]] ([[HFrEF]])==
	<span style="font-size:85%">'''Abbreviations:''' '''ARNi:''' [[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]

	~~===~~ 2022 AHA/ACC/HFSA ~~Guidelines~~ for ~~the Management~~ of ~~Heart Failure ===~~
			The 2022 AHA/ACC/HFSA approach to chronic stage C HFrEF (LVEF ≤40%) emphasizes early initiation of the 4 pillars of guideline-directed medical therapy (GDMT), including ARNI (preferred) or ACEi/ARB, an evidence-based beta-blocker, a MRA in eligible patients, and an SGLT2 inhibitor, alongside diuretics for relief of congestion, with subsequent dose uptitration to target as tolerated. In parallel, patients should be evaluated for device and interventional therapies (e.g., ICD/CRT in appropriate candidates) and referred to an HF specialty team if progressing to advanced/refractory symptoms despite optimized GDMT.

	{{familytree/start \|summary=HFrEF Management Algorithm (2022 AHA/ACC Guidelines)}}		{{familytree/start \|summary=HFrEF Management Algorithm (2022 AHA/ACC Guidelines)}}

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	{{familytree/end}}		{{familytree/end}}
			<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]''
			{\|
			! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''
			\|-
			\|}

	===Treatment Algorithm for [[Guideline-Directed Medical Therapy]] Including Novel Therapies===		===Treatment Algorithm for [[Guideline-Directed Medical Therapy]] Including Novel Therapies===

	{{familytree/start}}		{{familytree/start}}
	{{familytree \| \| \| \| \| \| \| \| \| \| A01 \| \| \| \| \| \|A01=[[Heart failure ]] reduced [[EF]], stage C, treatment}}		{{familytree \| \| \| \| \| \| \| \| \| \| A01 \| \| \| \| \| \|A01=[[Heart failure ]] reduced [[EF]], stage C, treatment}}
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	{{familytree \| \| G0 \| \| \|G2 \| \| G3\| \| G4 \| \| G5 \| \| \|G0=[[Aldosterone antagonist]]\|G2= [[SGLT2 inhibitor]]\|G3=[[Diuretic]] agents\|G4= [[Hydralazine]] + [[Isosorbide dinitrate]]\|G5=[[Ivabradine]]}}		{{familytree \| \| G0 \| \| \|G2 \| \| G3\| \| G4 \| \| G5 \| \| \|G0=[[Aldosterone antagonist]]\|G2= [[SGLT2 inhibitor]]\|G3=[[Diuretic]] agents\|G4= [[Hydralazine]] + [[Isosorbide dinitrate]]\|G5=[[Ivabradine]]}}
	{{familytree/end}}		{{familytree/end}}
			<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above algorithm adopted from 2021 AHA/ACC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2021 AHA/ACC Guideline</small>''
	\|-		\|-
	\|}		\|}

	== Management of [[patients]] with [[heart failure with preserved ejection fraction]] ([[HFrEF]])==		== Management of [[patients]] with [[heart failure with preserved ejection fraction]] ([[HFrEF]])==
	~~<span style="font-size:85%">'''Abbreviations:''' '''ARNi:''' [[Angiotensin receptor-neprilysin~~ inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors		HFpEF management in the 2022 AHA/ACC/HFSA framework recommends optimizing comorbidities (especially hypertension), using diuretics for congestion, initiating an SGLT2 inhibitor to reduce HF hospitalizations and CV mortality, and selectively adding MRAs, ARBs, or ARNI to reduce hospitalizations, particularly when LVEF is at the lower end of the preserved range.

	~~=== 2022 AHA/ACC/HFSA Guidelines for the Management of Heart Failure ===~~
	{{familytree/start \|summary=2022 AHA/ACC/HFSA HFpEF Management Algorithm}} {{familytree \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| A01 \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \|A01='''Symptomatic HF'''<br/>LVEF ≥50%}} {{familytree \| \| \| \|,\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|^\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|.\| }} {{familytree \| \| \| B01 \| \| \| \| \| \| \| \| \| \| \| B02 \| \| \| \| \| \| B03 \| \| \| \| \| \| \| \| B04 \| \| \| \| \| \| B05 \| \|B01='''Diuretics,'''<br/>'''as needed'''<br/>(Class I)\|B02='''SGLT2i'''<br/>(Class IIa)\|B03='''ARNi'''<br/>(Class IIb)\|B04='''MRA'''<br/>(Class IIb)\|B05='''ARB'''<br/>(Class IIb)}} {{familytree/end}} <small>Greater benefit in patients with LVEF closer to 50%.</small>		{{familytree/start \|summary=2022 AHA/ACC/HFSA HFpEF Management Algorithm}} {{familytree \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| A01 \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \|A01='''Symptomatic HF'''<br/>LVEF ≥50%}} {{familytree \| \| \| \|,\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|^\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|.\| }} {{familytree \| \| \| B01 \| \| \| \| \| \| \| \| \| \| \| B02 \| \| \| \| \| \| B03 \| \| \| \| \| \| \| \| B04 \| \| \| \| \| \| B05 \| \|B01='''Diuretics,'''<br/>'''as needed'''<br/>(Class I)\|B02='''SGLT2i'''<br/>(Class IIa)\|B03='''ARNi'''<br/>(Class IIb)\|B04='''MRA'''<br/>(Class IIb)\|B05='''ARB'''<br/>(Class IIb)}} {{familytree/end}} <small>Greater benefit in patients with LVEF closer to 50%.</small>
			<span style="font-size:85%">'''ARNi:''' [[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors
			{\|
			! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''
			\|-
			\|}

	== Congestive heart failure treatment summary based on 2021 AHA/ACC Guideline <ref name="pmid33755495">{{cite journal \|vauthors=Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS \|title=2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure) \|journal=Circ Cardiovasc Qual Outcomes \|volume=14 \|issue=4 \|pages=e000102 \|date=April 2021 \|pmid=33755495 \|pmc=8059763 \|doi=10.1161/HCQ.0000000000000102 \|url=}}</ref> ==		== Congestive heart failure treatment summary based on 2021 AHA/ACC Guideline <ref name="pmid33755495">{{cite journal \|vauthors=Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS \|title=2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure) \|journal=Circ Cardiovasc Qual Outcomes \|volume=14 \|issue=4 \|pages=e000102 \|date=April 2021 \|pmid=33755495 \|pmc=8059763 \|doi=10.1161/HCQ.0000000000000102 \|url=}}</ref> ==
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	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2021 AHA/ACC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table is adopted from 2021 AHA/ACC Guideline
	\|-		\|-
	\|}		\|}