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ACCF/AHA Update Covers Heart Failure in Adults

New section covers diagnosis, treatment, discharge issues in hospitalized patients

FRIDAY, March 27 (HealthDay News) -- Updated American College of Cardiology Foundation/American Heart Association guidelines on heart failure in adults include new recommendations for hospitalized patients, and the guidelines were published online March 26 in the Journal of the American College of Cardiology.

Mariell Jessup, M.D., of the University of Pennsylvania Department of Medicine in Philadelphia, and co-authors write that many heart failure patients present with decreased exercise tolerance or fluid retention. Two-dimensional echocardiogram along with Doppler flow studies provides the most useful diagnostic test in assessing heart failure patients, they write.

Recommendations for hospitalized patients include determining patients' volume status and adequacy of systemic perfusion; prompt identification of acute coronary syndrome, severe hypertension, atrial and ventricular arrhythmias, infections, and pulmonary emboli; and the use of oxygen to treat hypoxemia-related symptoms

"Heart failure hospitalizations account for a substantial portion of the overall costs of caring for patients with heart failure and may be associated with a staggering degree of morbidity and mortality, particularly in the elderly population. It is evident that the prognosis after an index hospitalization for heart failure is ominous, with a 50 percent rate of readmission at six months and a 25 percent to 35 percent incidence of death at 12 months. Indeed, many heart failure trials now incorporate the need for hospitalization as an important end-point with which to evaluate a new therapy," the authors write.

Many of the co-authors disclosed a variety of relationships with pharmaceutical and other private companies, as well as other organizations.

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