Vnitr Lek 2009, 55(Suppl 1):9-12

Chronic cardiac failure treatment in an internal medicine ambulance

J. Vítovec^1,*, L. Špinarová¹, J. Špinar²

¹ I. interní kardio-angiologická klinika Lékařské fakulty MU a FN u svaté Anny Brno, přednosta prof. MUDr. Jiří Vítovec, CSc., FESC

² Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC

Management of chronic heart failure in an internal medicine ambulance at present is based on blockade of the rennin-angiotenzin-aldosterone system (RAAS) with angiotenzin-converting enzyme inhibitors (ACEI) or angiotenzin II receptor₁ (AT₁) blockers - sartans (ARB) or, alternatively, aldosterone receptor blockers (BAR) and, in addition, blockade of the sympathetic nervous system with beta-blockers (BB). When water retention occurs, diuretics are added to this combination. Should this treatment be ineffective, or in case of atrial fibrillation, digoxine is added. Further therapeutic modalities are more suitable for specialized cardiology and hospital care where drugs are administered intravenously or approaches other than pharmacological are used, including resynchronization therapy and internal defibrillator implantation or, in indicated cases, inclusion of the patient in a transplantation programme.

Keywords: heart failure; ACE inhibitors; angiotenzin receptor blockers; aldosterone blockers; beta-blockers; digoxine; diuretics

Received: April 3, 2009; Published: February 1, 2009  Show citation