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Showing posts from April, 2018

Heart Failure with reduced ejection fraction Management 2017 Update, ACC/AHA Guidelines, Summary

In heart failure, the heart fails to pump enough blood to maintain sufficient blood flow throughout the body. The goal of the heart is to maintain the cardiac output, which is the amount of blood which is pumped by the heart in one minute. Our body tries to compensate by  Increasing the heart rate.  Activating the Renin-Angiotensin-Aldosterone-System (RAAS), which cause an increase in blood volume and vasodilatation.  Sympathetic activation, which causes tachycardia and cardiac remoulding.  The release of BNP, in response to stretch of cardiac muscle which causes natriuresis and inhibition of aldosterone. These compensatory mechanisms increase the load on the failing heart. Our goal is to inhibit these compensatory mechanisms to decrease the further load on the failing heart which these compensatory mechanisms (especially activation of RAAS and sympathetic system) put. The BNP release is not enough in the presence of activated RAAS.  Thus,  we will inhibit the RAAS by