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Heart failure - chronic - Management
How should I manage confirmed heart failure with preserved left ventricular systolic ejection fraction?
- Prescribe a low- to medium-dose diuretic — up to 80 mg furosemide (or equivalent), if necessary, to relieve symptoms of fluid overload.
- Seek specialist advice if the person does not gain sufficient relief of symptoms from this and additional drug treatments are being considered.
- Ensure that any comorbidities and precipitating factors, such as hypertension, myocardial ischaemia, and atrial fibrillation, are optimally managed.
- Angiotensin-converting enzyme (ACE) inhibitors and beta-blockers may be indicated to treat comorbidities.
- Monitor medical and psychosocial status regularly; tailor the details and frequency of monitoring to the individual's needs.
- Give self-care advice and provide information about online resources, driving, sexual activity, and travel.
- Include family members or carers in education and decision making when appropriate.
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