Managing patients with chronic heart failure

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Clinicians will encounter more patients at risk for CHF as the population ages and cardiovascular risk factors become more prevalent.
Clinicians will encounter more patients at risk for CHF as the population ages and cardiovascular risk factors become more prevalent.
The following article is part of The Clinical Advisor's coverage from the 2017 National Conference of the American Academy of Nurse Practitioners in Philadelphia. Our staff will be reporting live on the latest news and clinically relevant practice information from leading NPs in many specialty areas. Check back for ongoing updates from AANP 2017. 

PHILADELPHIA – Successful management of the growing population of patients at risk for congestive heart failure (CHF) depends on understanding risk factor reduction and strict adherence to established guidelines, according to research presented at the American Association of Nurse Practitioners (AANP) 2017 National Conference.

Nancy Eleanor Stone, PhD, NP-C, APRN-BC, CCRN, noted in her presentation that history and physical examination findings that show symptoms of congestion or end-organ hypoperfusion are used to make the diagnosis of heart failure, as opposed to a single test. Imaging studies that document systolic or diastolic dysfunction and biomarkers are also useful, she added.

“Despite the growing prevalence, novel screening techniques and therapeutic directions have improved the outlook for patients with CHF by focusing not only on symptom control but also on addressing CHF etiology,” Dr Stone noted.

Therapy for CHF should include:

  • Identification and correction of reversible precipitants
  • Target-dose titration of medical therapy
  • Management of hospitalizations for decompensation

Preventing coronary artery disease and risk factor management with aggressive blood pressure control will help prevent new occurrences of left ventricular dysfunction, Dr Stone said. In addition, multiple cardiovascular conditions, including arrhythmias and valvular heart disease, may also lead to heart failure. Dr Stone emphasized that guideline-based management of these conditions is critical to preventing CHF.

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Reference

  1. Stone NE. Chronic heart failure: best practices from acute exacerbation to outpatient clinic. Presented at the American Association of Nurse Practitioners 2017 National Conference; June 20-25, 2017; Philadelphia.
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