RESUMEN
This guidelines summarize and evaluate all available evidence-at the time of the writing process-on a particular issue , with the aim of assisting physicians in selecting the best management strategies for an individual pa-tient with given condition , taking into account the impact on outcome , as well as the risk-benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help physicians to make decisions in their daily practice. However , the final decisions concerning an individual patient must be made by the responsible physi-cian(s). A great number of guidelines have been issued in recent years by the European Society of Cardiology (ESC) , as well as by other societies and organizations. ESC guidelines represent the official position of the ESC on a given topic and are regularly updated.
RESUMEN
Heart failure is a common cardiovascular disease with high morbidity and mortality. Unlike western countries where heart failure is predominantly a disease of the elderly, in India it affects younger age group. Important risk factors include coronary artery disease, hypertension, diabetes mellitus, valvular heart disease and cardiomyopathies. Plasma brain natriuretic peptide levels are helpful in the diagnosis of heart failure. Echocardiography is the primary imaging modality of choice, through recently cardiac magnetic resonance imaging (MRI) has been found to play an increasing role. Aim of management is to improve symptoms & enhance survival. Diuretics are important in relieving symptoms. Beta-blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers and adosterone antagonists improve survival in patients with impaired systolic function. Device therapy including cardiac resynchronization therapy and implantable cardiac defibrillators, though expensive are useful in selected patients. Unlike in patients with systolic heart failure where several therapies have been shown to improve survival, clinical trial results in diastolic heart failure have been disappointing and therapy in these patients is restricted to symptom improvement and risk factor control. Therapies like stem cell therapy are being evaluated in clinical trials and appear promising. Early diagnosis and appropriate therapy helps in reversing the process of remodelling and clinical improvement in most of the patients.