Author + information
- William W. Parmley, MD, FACC∗
- ↵∗Address for reprints: William W. Parmley, MD, 1186 Moffitt Hospital, San Francisco, California 94143.
Congestive heart failure is a common clinieal syndrome, with a relatively poor prognosis in its advanced stages. During the development of heart failure, there is a decline in myocardial contractility and activation of neurohormonal systems. An overshoot of some of these compensatory mechanisms sets the stage for therapeutic interventions. Any of the three therapeutic classes of drugs (inotropic drugs, diuretics or vasodilators) can be used as first-line therapy. Other classes can be added to produce additive effects on ventricular function. Because vasodilators have been shown to prolong life, they should be used routinely in patients with heart failure. Arrhythmias and sudden death are relatively common in heart failure, although the value of antiarrhythmic therapy is less certain. Although current therapy is very helpful in patients with heart failure, it is clear that preventive approaches will be more effective in decreasing morbidity and mortality.
☆ This article is part of a series of articles celebrating the 40th anniversary of the American College of Cardiology. The series attempts to set the stage for the future by describing current state of the art management of selected major cardiovascular problems and the basic knowledge that will provide directions for advances in diagnosis and therapy.
- Received November 29, 1988.
- Accepted December 15, 1988.