Insuficiencia cardíaca crónica

Abstract

Introduction and diagnosisThe aetiology of heart failure (HF) is very varied and recognising it can change the diagnostic and therapeutic approach and affect prognosis. In chronic heart failure, dyspnoea on exertion is the most common symptom, although very non-specific. Other symptoms include orthopnoea, paroxysmal nocturnal dyspnoea and lower limb oedema. The most common associated comorbidities are high blood pressure, diabetes mellitus, chronic obstructive pulmonary disease, respiratory sleep disorders, kidney dysfunction, anaemia/ferropenia, depression and cognitive impairment. Arrhythmias are also very common and worsen the prognosis. TreatmentIECA/ARA-II, beta- blockers and aldosterone antagonists are drugs that have been shown to improve survival in HF patients. Recently, a new compound (LCZ696) that combines an ARA-II (valsartan) and a neprilysin inhibitor (sacubitril) have proven better than an IECA (enalapril) in reducing the risk of death and hospitalisation due to HF.