Standardized treatment of heart failure

There are still many clinicians who believe that the prognosis of congestive heart failure (CHF) is comparable to that of malignancy, and that once diagnosed, life will be counted down. When CHF patients are treated with medications that follow strict guidelines, the death rate is significantly reduced. In most patients, cardiac function improves significantly, and in some patients, cardiac structure returns to normal. The benefits of heart failure treatment have 2 difficulties: ① The prognosis of heart failure patients is not straightforward, including when to start ACEI/ARB and β-blockers; ② How to gradually increase the dose to the target dose or maximum tolerated dose of the drug needs to be different from person to person. When applying ACEI/ARB and β-blockers, it is important to note that: ① Patients with decompensation should be given only after water and sodium retention are controlled and stabilized; ② Start with small or even very small doses and gradually increase the dose; ③ Patients need to be seen several times; ④ Patients should reach dry weight before applying β-blockers and maintain dry weight during the application of β-blockers; ⑤ Patients should be followed up and adhered to taking medications to improve prognosis, avoiding relapse, not reducing the dosage without authorization, withdrawing medications, ensuring the supply of medications, good doctor-patient relationship and high patient compliance are the basis to ensure good treatment results. In addition, it is strongly recommended that all hospitalized patients with heart failure and their health care providers develop written comprehensive discharge instructions and pay attention to the following aspects in the medical process: ① diet and post-discharge medication must be concerned with compliance and persistence; ② medication doses are adjusted upward to the recommended dose; ③ patients maintain a certain level of activity, regular follow-up, and daily weight measurement; ④ inform patients what to do if their symptoms worsen.