MANAGEMENT OF HEART FAILURE

Heart failure (HF) is the end stage of most diseases of the heart. The prevalence of HF varies between 3 – 20 per 1000 population, although in persons over the age of 65 years, it could be as high as 100 per 1000 population. The prognosis for HF is poor, far worse than some of the common cancers. Theone year mortality rate varies between 5% to 52% depending on the severity and the presence of co-morbidity. In a large community based study,about 40% of individuals with HF died within a year of initial diagnosis. About half of all deaths are sudden and may occur at any stage of the syndrome. Heart failureis an important cause of hospitalization accounting for about 10% of all medical admissions in Malaysia. About 45% of patients with HF are readmitted at least once within 12 months for acute decompensation. More recent epidemiological studies from the West seem to indicate that the prognosis has improved slightly with earlier detection of the condition and improved treatment strategies. The aims of management are:

• Preventing the development of HF
• Reducing the morbidity associated with the condition and improving the qualityof life of these patients
• Improving the survival of patients with HF

This guideline provides evidence based recommendations to help health care providers in the management of their patients with HF. Patient care should how ever be individualized and sound clinical judgement plays an important role in decision making.

Download