Treatment approaches to chronic decompensated heart failure

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Heart failure remains, to this day, a clinical challenge for both patients and clinicians. For stage A and B patients, lifestyle changes, healthier diets, risk factors control, and comorbidities management are recommended. In stage C, aside from the general management in stages A and B are considered, medications like MRA, ACE-I, Beta-blockers, and SGLT2i, which are the four pillars of GDMT, should be recommended due to their great benefit on the disease’s outcome. Besides GDMT, for specific cases, different medications, as well as device methods, should be considered. Unfortunately, some patients will eventually progress into the advanced stage (stage D) of HF. The general treatment in this stage of the disease consists mainly of inotropic medications and short-term and long-term mechanical circulatory support, with heart transplantation as the gold standard. Patients with advanced heart failure who are not eligible for heart transplantation or long-term mechanical circulatory support should be considered for palliative therapy.

Chronic decompensated heart failure, Treatment