Insuficiencia cardiaca avanzada

The heart failure evaluation is used to determine two primary areas:

• Evaluation for cause—This includes assessment for the presence of coronary artery disease, usually via cardiac catheterization, stress testing, echocardiogram, basic laboratory tests and/or ECG. Further testing could be needed based on what is found on these screening exams.
• Evaluation for factors that affect heart failure—This includes smoking, drug/alcohol use, high blood pressure, high cholesterol, abnormal heart rhythms, diabetes control, weight management, exercise, thyroid disease, anemia and sleep apnea.

• ACE inhibitors and ARBs—These medications are the cornerstone of heart failure treatments. While ACE inhibitors are the mainstay, ARBs may be used if you cannot tolerate ACE inhibitors. Both of these classes of drugs are used in heart failure treatment to reduce dilation and restore the heart to its normal shape.
• Beta blockers—Beta blockers provide the greatest potential benefit of all possible medications. Some beta blockers have been proven to help the heart return to its normal shape/function. These are started at low dose and are gradually adjusted, as tolerated.
• Aldosterone antagonists—The third line of medical therapy for treating patients with advanced heart failure is used in low doses in combination with the above. This medication is used to prevent your body from losing potassium, and it is a mild diuretic.
• Digoxin—This last line of medical therapy, in addition to the three above, has been shown to decrease the risk of hospitalizations for patients diagnosed with advanced heart failure.
• Diuretics—These are used to manage swelling and fluid retention for advanced heart failure.
• ICD (implantable cardioverter defibrillator)—This small device is placed under the skin of the chest. An ICD is designed to prevent a person from dying suddenly from a dangerous heart rhythm.
• Low-sodium diet—Patients with advanced heart failure should restrict sodium (salt) to 2,000 mg per day. Dietitians are available to assist you with your dietary plan.
• El ejercicio es muy importante. Por favor, hable con su proveedor.

• No medication has been shown to help a stiff heart relax; therefore, most therapies are aimed at controlling factors that worsen the condition, such as hypertension, diabetes and sleep apnea.
• Los diuréticos se pueden utilizar para ayudar a controlar la hinchazón y la retención de líquidos.

The better you can control your heart failure and the aggravating factors, the greater the possibility that you could postpone or prevent the need for a heart transplant or left ventricular assist device (LVAD).

• Miocardiopatía dilatada
• Cardiomiopatía isquémica
• Cardiomiopatía restrictiva (incluyendo amiloidosis, sarcoidosis, cardiomiopatía hipertrófica, no compactación del VI)
• Hipertensión de la arteria pulmonar