Congestive heart failure AHA recommendations Coordinating Care for Patients With Chronic HF

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Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
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Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2] ; Edzel Lorraine Co, D.M.D., M.D. [Mailto:efco@alum.up.edu.ph

2022 AHA/ACC/HFSA Guideline /2013 ACCF/AHA Guideline/2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Heart Failure in the Adult (DO NOT EDIT) [1] [2][3]

Palliative and Supportive Care, Shared Decision-Making, and End-of-Life (DO NOT EDIT) [1][2][3]

Class I
"1.For all patients with HF, palliative and supportive care- including high-quality communication, conveyance of prognosis, clarifying goals of care, shared decision-making, symptom management, and caregiver support- should be provided to improve QOL and relieve suffering. [4](Level of Evidence: C-LD) "
"2. For patients with HF being considered for, or treated with, life-extending therapies, the option for discontinuation should be anticipated and discussed through the continuum of care, including at the time of initiation, and reassessed with changing medical conditions and shifting goals of care.[5][6] (Level of Evidence: C-LD) "
Class IIa
"1.For patients with HF- particularly stage D HF patients being evaluated for advanced therapies, patients requiring inotropic support or temporary mechanical support, patients experiencing uncontrolled symptoms, major medical decisions, or multimorbidity, frailty, and cognitive impairment - specialist palliative care consultation can be useful to improve QOL and relieve suffering. [7][8][9](Level of Evidence: B-R) "

Vote on and Suggest Revisions to the Current Guidelines


External Links

References

  1. 1.0 1.1 Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  2. 2.0 2.1 2.2 Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE; et al. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
  3. 3.0 3.1 3.2 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016.DOI:10.1161/CIRCULATIONAHA.109.192064 PMID:19324967
  4. Datla S, Verberkt CA, Hoye A, Janssen DJA, Johnson MJ (2019). "Multi-disciplinary palliative care is effective in people with symptomatic heart failure: A systematic review and narrative synthesis". Palliat Med. 33 (8): 1003–1016. doi:10.1177/0269216319859148. PMID 31307276.
  5. Goldstein N, Carlson M, Livote E, Kutner JS (2010). "Brief communication: Management of implantable cardioverter-defibrillators in hospice: A nationwide survey". Ann Intern Med. 152 (5): 296–9. doi:10.7326/0003-4819-152-5-201003020-00007. PMC 2832227. PMID 20194235.
  6. McIlvennan CK, Jones J, Allen LA, Swetz KM, Nowels C, Matlock DD (2016). "Bereaved Caregiver Perspectives on the End-of-Life Experience of Patients With a Left Ventricular Assist Device". JAMA Intern Med. 176 (4): 534–9. doi:10.1001/jamainternmed.2015.8528. PMID 26998594.
  7. Rogers JG, Patel CB, Mentz RJ, Granger BB, Steinhauser KE, Fiuzat M; et al. (2017). "Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial". J Am Coll Cardiol. 70 (3): 331–341. doi:10.1016/j.jacc.2017.05.030. PMC 5664956. PMID 28705314.
  8. Bekelman DB, Allen LA, McBryde CF, Hattler B, Fairclough DL, Havranek EP; et al. (2018). "Effect of a Collaborative Care Intervention vs Usual Care on Health Status of Patients With Chronic Heart Failure: The CASA Randomized Clinical Trial". JAMA Intern Med. 178 (4): 511–519. doi:10.1001/jamainternmed.2017.8667. PMC 5876807. PMID 29482218.
  9. O'Donnell AE, Schaefer KG, Stevenson LW, DeVoe K, Walsh K, Mehra MR; et al. (2018). "Social Worker-Aided Palliative Care Intervention in High-risk Patients With Heart Failure (SWAP-HF): A Pilot Randomized Clinical Trial". JAMA Cardiol. 3 (6): 516–519. doi:10.1001/jamacardio.2018.0589. PMC 6128511. PMID 29641819.
  10. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW (May 2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check |pmid= value (help).
  11. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112 (12):e154-235. DOI:10.1161/CIRCULATIONAHA.105.167586PMID:16160202

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