n CME : Your SA Journal of CPD - Dilated cardiomyopathy and treatment of chronic heart failure : main article

Volume 24, Issue 4
  • ISSN : 0256-2170



Prevention of heart failure is of the utmost importance in patients at risk. <BR>Heart failure should never be the only diagnosis. <BR>All patients with symptoms of heart failure should be investigated for the presence of left ventricular dysfunction. <BR>Patients should be advised to monitor weight gain. <BR>Patients with severe heart failure often develop malnutrition that is called cardiac cachexia, an important predictor of reduced survival. <BR>In acute heart failure physical rest or bed rest is recommended. <BR>Stable patients should be encouraged to and advised on how to carry out daily physical activities that do not induce symptoms. <BR>All patients with heart failure should be treated with both an ACE-inhibitor and a beta-blocker up-titrated to recommended doses if tolerated. <BR>An implantable cardioverter defibrillator (ICD) in combination with bi-ventricular pacing can be considered in patients who survived cardiac arrest or who have sustained ventricular tachycardia which is associated with severe heart failure (NYHA FC III - IV) with a left ventricular ejection fraction &lt;U&gt;&lt;&lt;/U&gt; 35% and QRS duration of &lt;U&gt;&gt;&lt;/U&gt; 120 ms to improve mortality and morbidity.

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