Abstract
Heart failure is deemed refractory when it is severe enough to resist maximal standard medical therapy. Before reaching that conclusion, however, confirm the accuracy of diagnosis, absence of other illness, full compliance with therapy, absence of complicating drug therapy, and other obvious points. Ensure, too, that the patient has indeed received optimal therapy, which may include the following, as indicated: restriction of dietary salt and water, aggressive diuresis, digoxin when left ventricular ejection fraction is less than 35%, an angiotensin-converting enzyme inhibitor given at a dosage proved to be effective and safe, a β-blocker, an angiotensin II receptor antagonist, and anticoagulation. For ischemic cardiomyopathy with large areas of injured but viable tissue, coronary artery bypass graft surgery can improve survival, ventricular function, and symptoms. Left ventricular assist devices can serve as bridges to heart transplantation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 571-580 |
| Number of pages | 10 |
| Journal | Journal of Critical Illness |
| Volume | 14 |
| Issue number | 10 |
| State | Published - 1999 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
Refractory heart failure : Optimizing therapy, managing end-stage disease. A guide to making the best use of standard and new treatments. / Sangrigoli, R.; Pina, Ileana L.
In: Journal of Critical Illness, Vol. 14, No. 10, 1999, p. 571-580.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Refractory heart failure
T2 - Optimizing therapy, managing end-stage disease. A guide to making the best use of standard and new treatments
AU - Sangrigoli, R.
AU - Pina, Ileana L.
PY - 1999
Y1 - 1999
N2 - Heart failure is deemed refractory when it is severe enough to resist maximal standard medical therapy. Before reaching that conclusion, however, confirm the accuracy of diagnosis, absence of other illness, full compliance with therapy, absence of complicating drug therapy, and other obvious points. Ensure, too, that the patient has indeed received optimal therapy, which may include the following, as indicated: restriction of dietary salt and water, aggressive diuresis, digoxin when left ventricular ejection fraction is less than 35%, an angiotensin-converting enzyme inhibitor given at a dosage proved to be effective and safe, a β-blocker, an angiotensin II receptor antagonist, and anticoagulation. For ischemic cardiomyopathy with large areas of injured but viable tissue, coronary artery bypass graft surgery can improve survival, ventricular function, and symptoms. Left ventricular assist devices can serve as bridges to heart transplantation.
AB - Heart failure is deemed refractory when it is severe enough to resist maximal standard medical therapy. Before reaching that conclusion, however, confirm the accuracy of diagnosis, absence of other illness, full compliance with therapy, absence of complicating drug therapy, and other obvious points. Ensure, too, that the patient has indeed received optimal therapy, which may include the following, as indicated: restriction of dietary salt and water, aggressive diuresis, digoxin when left ventricular ejection fraction is less than 35%, an angiotensin-converting enzyme inhibitor given at a dosage proved to be effective and safe, a β-blocker, an angiotensin II receptor antagonist, and anticoagulation. For ischemic cardiomyopathy with large areas of injured but viable tissue, coronary artery bypass graft surgery can improve survival, ventricular function, and symptoms. Left ventricular assist devices can serve as bridges to heart transplantation.
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UR - http://www.scopus.com/inward/citedby.url?scp=0032703724&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:0032703724
VL - 14
SP - 571
EP - 580
JO - Journal of Critical Illness
JF - Journal of Critical Illness
SN - 1040-0257
IS - 10
ER -