A. Schneeweiss (auth.), Professor Dr. Herbert Viefhues, Dr.'s Chronic Heart Failure: I. Quality of Life II. Nitrate PDF

By A. Schneeweiss (auth.), Professor Dr. Herbert Viefhues, Dr. phil. Wolfgang Schoene, Professor Dr. Dr. med. R. Rychlik, Professor Dr. med. Asher Kimchi, Professor Dr. med. Basil S. Lewis, Dr. Marija Weiss (eds.)

A. Schneeweiss even though the syndrome of congestive middle failure has been well-known decades in the past, the method for its overview and remedy has until eventually lately, been partial and 'fragmentary'. a number of features of the disorder were handled in keeping with the review instruments and healing measures on hand at every one interval. This procedure ended in a number of the maximum achievements within the administration of center failure but additionally left many points overlooked and in addition ended in numerous paradoxes. Examples of the achievements and boundaries of the 'fragmentary' ap­ proach are using diuretics and hemodynamic measurements. The devel­ opment of diuretics has supplied us with a massive device for assisting pa­ tients whose major challenge used to be edema. The good fortune of diuretics masked the truth that their use may possibly usually be hemodynamically unsound and they might lessen cardiac output. merely decades after their advent has using diuretics came across its acceptable position. Hemodynamic tracking has long gone through a similar direction. the good contribu­ tion of constant bedside hemodynamic measurements to figuring out center failure ended in over-usage by means of many clinicians, who chanced on themselves treating hemodynamic charts instead of sufferers. It took nearly a decade to achieve that hemodynamic development, even within the continual atmosphere, doesn't unavoidably suggest symptomatic development or a rise in workout capac­ ity.

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Additional info for Chronic Heart Failure: I. Quality of Life II. Nitrate Therapy

Example text

These are mainly digitalis, diuretics and vasodilators. 3. The prognosis is poor once "heart failure" has been diagnosed; the disease usually takes a progressive course, and cure is out of the question. The lethality rate is approximately 50% at 5 years from first diagnosis. 4. Based on the various studies, heart failure proves to be a problem in older people above the age of around 45 but it is particularly extreme in persons above the age of 60. In men of all age groups, the risk is much greater than in women (2:1).

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McKee PA, Castelli WP, McNamara PM, Kannel WB (1971) The natural history of congestive heart failure: the Framingham study. N Engl J Med 285: 1441-1446 21a. Neumann J, Scholz H, Doring V, Schmitz W, v. Meyerinck L, Kalmar P (1988) Increase in myocardial G-proteins in heart failure. Lacet II: 936-937 22. Packer M (1986) The role of vasodilator therapy in the treatment of severe chronic heart failure. Drugs 32: 13-26 23. Packer M (1987) Do vasodilators prolong life in heart failure? N Engl J Med 316 (23): 1471-1473 24.

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