INTRODUCTION

CentraCare Clinic Outpatient Guidelines for Heart Failure in Adult of 6/2000.

Update 2002.

Update 2003.

Update 2004. ( Complete in mid 2005)

World Wide Web version

Advantage of Web format:

• Readily available in practically every hospital, clinic, office, desk top, with internet connection computer.
• Easy to change, update, in comparison to a print format.
• Multiple printing options.
• May connect to other information available on the world wide web.

PURPOSE OF THIS GUIDELINES

• Many major heart failure guidelines have excellent review of databases. They are very good references. However, the format is typically not for use as a manual for day to day practice.
• This guideline is prepared based on those major heart failure guidelines for more practical use.
• Provide and encourage evidence-based practice guidelines in CentraCare Clinic.
• Primarily covers outpatient management of adult heart failure patients with systolic dysfunction. Heart failure with diastolic dysfunction or heart failure with preserved systolic function is only mentioned briefly. Acute care for inpatient care is not covered.
• Emphasis on pharmacological, non pharmacologic-educational and follow up management.

Terminology

• Heart Failure is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood.
• Heart failure with systolic dysfunction patients are those with left ventricular ejection fraction (LVEF) <40-45%.
• Heart failure with diastolic dysfunction or heart failure with preserved systolic function patients are those with LVEF >40-45%.
• Asymptomatic heart failure refers to patients with abnormal left ventricular function without symptom.
• Congestive heart failure refers to heart failure patients with evidence of fluid overload-congestion.