Heart Failure - Big Picture

Question 1

Agents that reduce hospitalizations, death, or interrupt disease progression

Answer 1

• ACE-inhibitors/Angiotensin Receptor blockers (ARBs) ± natriuretic peptide inhibitor
• Beta-blockers
• Aldosterone Antagonists
• Hydralazine/nitrate

Question 2

Agents that reduce hospitalizations or improve symptoms without improving survival

Answer 2

• Diuretics
• Ivabradine
• Digoxin

Question 3

Which patients should be on ACE-inhibitors/Angiotensin Receptor blockers (ARBs) ± natriuretic peptide inhibitor?

Answer 3

All patients with reduced EF unless contraindication

Question 4

Which patients should be on Beta-blockers?

Answer 4

All patients with reduced EF unless contraindication

Question 5

Which patients should be on Aldosterone Antagonists?

Answer 5

All patients with reduced EF PLUS certain criteria unless contraindication

Question 6

Which patients should be on Hydralazine/nitrate?

Answer 6

All patients with reduced EF PLUS certain criteria unless contraindication

Question 7

Which patients should be on Diuretics?

Answer 7

Patients with congestive symptoms

Question 8

Which patients should be on Ivabradine?

Answer 8

Patients with reduced EF whose heart rate is ≥ 70 bpm in spite of optimized beta-blockade.

Question 9

Which patients should be on Digoxin?

Answer 9

Patients with low EF who continue to require hospitalization in spite of being optimized on life-saving medications

Question 10

What is a natriuretic peptide inhibitor?

Answer 10

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