Chronic Heart Failure - Are We Able to Diagnose and Treat It Correctly in ClinicalPractice?

Overview

The author draws attention to difficulties in the diagnosis of chronic heart failure. If the clinicaldiagnosis is not established objectively by assessment of left ventricular systolic function usingechocardiography, the diagnosis may be in as many as 50 % of patients incorrect. Heart failureis not properly diagnosed as apparent from American and British studies, frequently it is notalso properly treated. ACE inhibitors should be the drugs of choice in the treatment not only ofchronic heart failure but also of asymptomatic left ventricular systolic dysfunction in particularin patients after myocardial infarction because they reduce the cardiovascular and totalmortality and improve the life prognosis. These drugs should be used in all patients with heartfailure of all stages. Despite this American and British data indicate that only about half of thepatients is treated by these drugs. As the number of hospital admissions on account of heartfailure is rising during the past 10 years (as a result of better treatment of cardiovasculardiseases and prolongation of life), it is particularly urgent to improve the diagnosis andtreatment of patients with heart failure. Data on major errors in the diagnosis and treatmentcoming mainly from the USA and Great Britain are alarming. Therefore the programmeIMPROVEMENT was started in more than 10 European countries incl. The Czech and SlovakRepublics to ensure the state of diagnosis and treatment among general practitioners and toimprove the situation by special educational activities.

Key words:
heart failure - diagnosis - treatment - ACE inhibitors.