This paper is based on retrospective and observational data from the author’s 14 years of practice as a general cardiologist in a rural community hospital, which reported 62 cases with initial encounters as inpatients and followed as outpatients over 14 years, which applied the knowledge of physiology and pathophysiology to everyday practice in treating congestive heart failure (CHF). The 62 patients were reported to have had a normal life with a significantly lower readmission rate [1]. This paper illustrates the application of the author’s understanding of the physiology and pathophysiology of cardiovascular and renal systems to the treatment of CHF patients. It intends to arouse attention in cardiology regarding our current treatment of CHF patients. It is hoped that this paper will help us improve the quality of life of millions of patients suffering from CHF and lower admission and readmission rates of CHF patients and the cost of CHF treatment by tens of billions of dollars annually.
References
[1]
Wang, D.Y. and Wang, J. (2024) Congestive Heart Failure: Treatment of Symptoms or Causes. World Journal of Cardiovascular Diseases, 14, 480-489. https://doi.org/10.4236/wjcd.2024.148041
[2]
Yancy, C.W., Jessup, M., Bozkurt, B., Butler, J., Casey, D.E., Drazner, M.H., et al. (2013) 2013 ACCF/AHA Guideline for the Management of Heart Failure. Circulation, 128, e240-327. https://doi.org/10.1161/cir.0b013e31829e8776
[3]
Heidenreich, P.A., et al. (2022) 2022 AHA/ACC/HFSA Guideline for the Manage-ment of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145, e895-e1032. https://doi.org/10.1161/CIR.0000000000001073
[4]
Waagstein, F. and Rutherford, J.D. (2017) The Evolution of the Use of Β-Blockers to Treat Heart Failure. Circulation, 136, 889-893. https://doi.org/10.1161/circulationaha.117.029934
[5]
Heidenreich, P.A., Fonarow, G.C., Opsha, Y., Sandhu, A.T., Sweitzer, N.K., Warraich, H.J., et al. (2022) Economic Issues in Heart Failure in the United States. JournalofCardiacFailure, 28, 453-466. https://doi.org/10.1016/j.cardfail.2021.12.017
[6]
Virani, S.S., Alonso, A., Benjamin, E.J., Bittencourt, M.S., Callaway, C.W., Carson, A.P., et al. (2020) Heart Disease and Stroke Statistics—2020 Update: A Report from the American Heart Association. Circulation, 141, e139-e596. https://doi.org/10.1161/cir.0000000000000757
[7]
Heidenreich, P.A., Albert, N.M., Allen, L.A., Bluemke, D.A., Butler, J., Fonarow, G.C., et al. (2013) Forecasting the Impact of Heart Failure in the United States. Circulation:HeartFailure, 6, 606-619. https://doi.org/10.1161/hhf.0b013e318291329a
[8]
van Walraven, C., Jennings, A. and Forster, A.J. (2011) A Meta‐analysis of Hospital 30-Day Avoidable Readmission Rates. JournalofEvaluationinClinicalPractice, 18, 1211-1218. https://doi.org/10.1111/j.1365-2753.2011.01773.x
[9]
Villaschi, A., Pellegrino, M., Condorelli, G. and Chiarito, M. (2024) Diuretic Combination Therapy in Acute Heart Failure: An Updated Review. CurrentPharmaceuticalDesign, 30, 2597-2605. https://doi.org/10.2174/0113816128316596240625110337
[10]
Ahmed, A., Husain, A., Love, T.E., Gambassi, G., Dell’Italia, L.J., Francis, G.S., Gheorghiade, M., Allman, R.M., Meleth, S. and Bourge, R.C. (2006) Heart Failure, Chronic Diuretic Use, and Increase in Mortality and Hospitalization: An Observational Study Using Propensity Score Methods. European Heart Journal, 27, 1431-1439.
[11]
William, E. and Cayley Jr., M.D. (2006) Eau Claire Family Medicine Residency, University of Wisconsin, Eau Claire, Wisconsin Diuretics for Treatment of Patients with Heart Failure? American Family Physician, 74, 411-413.