Heart failure management – A multidisciplinary approach: Literature review and single center experience

Abstract

Introduction: Heart failure is a severe chronic disease affecting millions of people worldwide, decreasing their quality of life and having a high burden of mortality. The treatment of the heart failure evolved in a spectacular way in the last years with the development of the new medical therapies, interventions and devices. Unfortunately, outcomes remain poor and need proper implementation of the current knowledge. A multidisciplinary team approach is considered the best way to deliver care for heart failure patients. Objective: To make a short review of recent data provided by the trials and to describe why the multidisciplinary team approach is necessary during heart failure care. To describe how is the heart failure management performed in our center. Literature review and our center experience: We analyzed the European Society of Cardiology Guidelines for the diagnosis and treatment of acute and chronic heart failure, made a literature search in Pubmed database and selected the most important articles related to the heart failure management, giving special attention to the evidence provided by the clinical trials. We describe how we implemented the recommendation and multidisciplinary team approach in Medpark International Hospital, Chisinau, Republic of Moldova. There are pharmacological management and a non-pharmacological management available. Non-pharmacological management of the heart failure includes cardiac surgery, interventional cardiology, electrophysiology, sleep-disordered breathing treatment, physical therapy, patient education, etc. Many cases of HF patients need a Heart Team approach that includes a cardiac surgeon, an interventional cardiologist, an electrophysiologist and a general cardiologist. We implemented the multidisciplinary approach providing better care for our patients. Conclusions: The care of heart failure is multidisciplinary and needs some super-specialized team members. A multidisciplinary team approach is considered the best way to deliver care for HF patients. There are lot of tricky situations when a decision made without the team support could be a wrong decision. To avoid such situations is important to implement the MDT approach and to continually educate the team members, keeping the pace with the HF management updates.