Before the first National Heart Failure Day on November 26, 2015, it is necessary to talk about the standardized treatment of heart failure. The general public is very familiar with common cardiovascular diseases such as myocardial infarction and stroke, but most people know very little about the concept of heart failure, and the level of awareness and attention to heart failure is extremely low. So what is heart failure? Heart failure is a complex group of clinical syndromes in which the filling or ejection capacity of the ventricles is impaired due to any structural or functional abnormality of the heart, and its main manifestations are dyspnea and weakness (limited activity tolerance), and fluid retention (pulmonary stasis and peripheral edema). Heart failure is a serious and terminal stage of various cardiac diseases, with a high incidence, and is one of the most important cardiovascular diseases today. In particular, with the onset of winter, the temperature gradually goes lower, the blood pressure of hypertensive patients gradually goes higher, and the frequency of myocardial ischemic episodes in patients with coronary artery disease increases significantly, leading to a significant increase in the occurrence of heart failure downstream of these diseases. Recently the ward has admitted many patients with acute left heart failure and acute coronary syndrome with coronary artery disease due to sudden increase in blood pressure, resulting in heart failure due to myocardial ischemia and infarction. Together with atrial fibrillation, heart failure is one of the two major unconquered strongholds in the cardiovascular field. As Brauwald says, “Over the past half century, there have been significant advances in the prevention, diagnosis, and management of cardiovascular disease, with a 2/3 reduction in cardiovascular deaths in developed countries, and significant reductions in death rates from ACS, valvular and congenital heart disease, hypertension, and arrhythmias. Only the area of heart failure is an exception.” Heart failure is the leading cause of hospitalization in the population of patients over 65 years of age. Patients have a poor long-term prognosis, with a 5-year survival rate of less than 50% and a death rate 2-3 times higher than that of late-stage cancers such as breast and bowel cancer, seriously endangering people’s health. However, on the websites of “” and “Sina Love Doctor”, I received consultations from patients all over the country and found that many places, hospitals, doctors and patients do not know enough about heart failure, and the treatment is very irregular, resulting in many patients with heart failure The quality of life is significantly reduced, and the disability and mortality rates are significantly increased. The National Cardiovascular Center, the Heart Failure Committee of the Chinese Medical Association, and the China Health Promotion Foundation have jointly initiated the designation of November 26 each year as “National Heart Failure Day”, and the theme of the 2015 National Heart Failure Day is The theme of National Heart Failure Day 2015 is “Recognize heart failure, standardize diagnosis and treatment”. So how to standardize the treatment of heart failure? (1) First of all, we must control the causes of heart failure. In the pre-heart failure stage, we must control the risk factors of heart failure, such as controlling blood pressure, actively treating coronary heart disease and controlling blood sugar, losing weight, avoiding alcohol abuse and controlling rheumatic fever to avoid the resulting structural changes of the heart. (2) Secondly, we should recognize the symptoms of heart failure. The most typical symptoms are shortness of breath, weakness and reduced exercise tolerance after activity, which gradually worsen and lead to inability to lie down at night and improvement after being forced to sit up, or nocturnal episodes of dyspnea, and early on, even during the day, life and work are as usual, and examination at the hospital may not reveal any problems. When the disease develops gradually, the coughing up of pink foamy sputum will be serious, and these symptoms are all symptoms of left heart failure. In contrast, edema of both lower limbs, weakness, poor appetite, large amount of chest and abdominal fluid and painful bruising of the liver are symptoms of right heart failure. If you have any of the above similar symptoms, you must go to the hospital as soon as possible to check whether you have heart failure. (3) If you have the above symptoms of heart failure, it is recommended to go to the hospital to check cardiac ultrasound, electrocardiogram and chest X-ray, as well as to draw blood to check routine blood, liver and kidney function, electrolytes, thyroid function, cerebral natriuretic peptide, etc. If myocardial infarction is suspected, ultrasensitive troponin T should also be checked, among which cerebral natriuretic peptide can be used to identify cardiogenic and respiratory dyspnea. If brain natriuretic peptide is less than 35ng/L, heart failure is not supported, while if brain natriuretic peptide is significantly increased, heart failure is strongly suggested. Cardiac ultrasound allows for quantitative analysis of cardiac structure and function, particularly the left ventricular end-diastolic internal diameter and left ventricular ejection fraction, both of which are particularly important. The purpose of these tests is: (a) to confirm the diagnosis of heart failure; (b) to also identify the cause of heart failure, and to treat the cause, which is always the most effective and correct treatment plan. Many patients who consult the Internet say they have “dilated cardiomyopathy heart failure”, but the end-diastolic internal diameter and ejection fraction of the left ventricle are within the normal range, so dilated cardiomyopathy can be completely excluded. However, there are many patients with heart failure for whom multiple tests have failed to find the cause, so “dilated cardiomyopathy” is considered clinically. Is there nothing that can be done? As Clyde W. Yancy, chair of the guideline committee and chairman of the Department of Cardiology at Northwestern University, said, “If the right patient with heart failure is treated in the right way at the right time, the risk of death can be reduced very significantly, perhaps by as much as 50 percent. For every 10 patients given the right treatment, it is likely to save at least 1 patient’s life”. (4) Anti-heart failure treatment, every time I answer the heart failure questions of netizens, I _COPY this paragraph: “Anti-heart failure drug treatment, if the patient has symptoms such as chest tightness and shortness of breath and edema, diuretics can be used first so that symptoms such as chest tightness and shortness of breath and edema are relieved and weight is stabilized to “dry weight “, then use angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists, betablockers and other drugs that can improve the prognosis of heart failure, slowly adjusting the dose to the target dose or the maximum tolerated dose, and using aldosterone receptor antagonists, generally at a maximum dose of 20 mg once a day.” Why is this passage repeatedly emphasized? The first thing to do is to use diuretics to relieve symptoms, not “infusion therapy”. Many of the users who consulted us repeatedly stressed the need to go to the hospital for infusion therapy during heart failure episodes, and to avoid going to the hospital for infusion to increase the burden on the heart for no reason. At the same time angiotensin converting enzyme inhibitors are the “cornerstone” of the treatment of heart failure and must be used unless there are contraindications. Betablockers are the only drugs that can reduce the rate of sudden death in heart failure, and improve the prognosis of heart failure, not only to use, but also to the target dose or maximum tolerated dose, better to use than not to use, large doses than small doses. However, early use may impair cardiac function, and after 3 months of use, cardiac function will improve significantly. Another drug to improve the prognosis of heart failure is aldosterone receptor antagonist, domestic is spironolactone, in fact, is also a diuretic, generally the maximum dose of 20mg a day can be, improve myocardial remodeling, no need to increase the dose. Standardize the treatment of heart failure, while controlling salt and water intake, measure out for in, prevent colds, exercise appropriately, and perform cardiac rehabilitation, let’s take action!