EDUCATION IN HEART
Heart failure
Disease monitoring of patients with chronic heart failure
Department of Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
Correspondence to:
Correspondence to:
Professors M G Nicholls and A M Richards
Department of Medicine, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand; barbara.griffin@chmeds.ac.nz
Keywords: disease monitoring; chronic heart failure; B-type natriuretic peptide
| The first 150 words of the full text of this article appear below. |
As is well known, heart failure in western countries is increasing in prevalence, places a heavy burden on health budgets (accounting for 1–2% of total health care costs), diminishes considerably quality of life, and notwithstanding major advances in management, has a bleak short-term prognosis. Among the challenges facing clinicians is how best to diagnose heart failure. In some patients this presents no problem, especially when symptoms and physical signs are "textbook", an underlying cause is obvious and basic, and simple investigations (chest x ray in particular) confirm clinical suspicions. But other patients are more challenging where the presence of obesity or chronic airways disease, for example, can obscure or confuse the clinical picture.
LONG TERM MANAGEMENT OF HEART FAILURE PATIENTS
Once any difficulties regarding the diagnosis of heart failure have been overcome, the question of how best to manage patients in the long term arises. Sad to say, evidence-based guidelines regarding drug treatment (relating to
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