Management of heart failure

WHO News and activities 110 Management of heart failure Heart failure is a major and growing public health problem worldwide. Its early diagnosis and effective treatment can, however, reduce morbidity, mortal­ity, and cost. Precise diagnosis of the underlying car­diac problem is the basis for optimal treatment of patients with suspected heart failure. WHO and the Council on Geriatric Cardiology have therefore recently produced a 25-page booklet containing guidelines for general practitioners on the modern diagnostic and therapeutic approach to dealing with patients who have suspected heart failure.b Among the topics covered in the guidelines are the following. • Pathophysiological and clinical definitions of heartfailure.• Clinical diagnosis of heart failure (diagnosticalgorithm, clinical history and examination, investi­gations, 12-lead electrocardiogram, chest radio­graph, and echocardiogram).• Diagnosis as the basis of treatment.• Types of heart failure and their treatment(etiology and pathophysiology, and commonly usedtreatments).• Treatment of left ventricular systolic dysfunction(treatment algorithm, nonpharmacological treat­ment/lifestyle modification, diuretics, ACE inhibi­tors, digoxin, other vasodilators, other drugs, andapparently intractable heart failure ).• Prevention of heart failure.The booklet also contains a bibliography of re­cent references to the original literature. Requests for single copies of the guidelines should be sent to Dr 1. Gyarfas, Cardiovascular Dis- • Concise guide to the management of heart failure. Geneva, World Health Organization/Council on Geriatric Cardiology Task Force on Heart Failure Education. WHO Bulletin OMS. Vol 741996 eases, World Health Organization, 1211 Geneva 27, Switzerland. WHO Bulletin OMS. Vol 74 1996 WHO News and activities 111