The Management of Chronic Heart Failure

Heart failure is a complex of symptoms — fatigue, shortness of breath, and congestion — that are related to the inadequate perfusion of tissue during exertion and often to the retention of fluid. Its primary cause is an impairment of the heart's ability to fill or empty the left ventricle properly.The management of heart failure can no longer be confined to the relief of symptoms. The processes that contribute to left ventricular dysfunction may progress independently from the development of symptoms (Figure 1). Treatment to prevent or delay the progression of left ventricular dysfunction may therefore be quite different . . .