Pharmacologic Treatment of Heart Failure



Heart failure can be caused by factors originating from within the heart (i.e., intrinsic disease or pathology) or from external factors that place excessive demands upon the heart. Intrinsic disease includes conditions such as dilated cardiomyopathy and hypertrophic cardiomyopathy. External factors that can lead to heart failure include long-term, uncontrolled hypertension, increased stroke volume (volume load; arterial-venous shunts), hormonal disorders such as hyperthyroidism, and pregnancy.

Acute heart failure develops rapidly and can be immediately life threatening because the heart does not have time to undergo compensatory adaptations. Acute failure (hours/days) may result from cardiopulmonary by-pass surgery, acute infection (sepsis), acute myocardial infarction, valve dysfunction, severe arrhythmias, etc. Acute heart failure can often be managed successfully by pharmacological or surgical interventions.  Chronic heart failure is a long-term condition (months/years) that is associated with the heart undergoing adaptive responses (e.g., dilation, hypertrophy) to a precipitating cause. These adaptive responses, however, can be deleterious in the long-term and lead to a worsening condition.

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