Advanced Heart Failure and Management Strategies Article

PMID: 21603448 Web of Science: 000420201400009

Cited authors

  • Gaddam, Krishna K.; Yelamanchili, Pridhvi; Sedghi, Yabiz; Ventura, Hector O.


  • The global healthcare burden attributable to heart failure is ever increasing. Patients presenting with refractory heart failure should be evaluated for compliance with medical regimens and sodium and/or fluid restriction, and every attempt should be made to optimize conventional strategies. Reversible causes such as ischemia should be identified and revascularization considered in persistently symptomatic patients, particularly those with a viable myocardium. Carefully selected patients who continue to deteriorate clinically in spite of optimization of medical therapy may be considered for advanced treatment strategies, such as continuous inotropic infusions, mechanical circulatory support devices, cardiac transplantation, or referral to hospice care. We discuss the clinical presentation and management of patients with advanced/refractory (Stage D) heart failure.

Publication date

  • 2009

Published in

International Standard Serial Number (ISSN)

  • 1524-5012

Start page

  • 227

End page

  • 233


  • 9


  • 4