Heart failure – a family physician’s approach
The most common causes of heart failure (HF) are various myocardial diseases, among which ischemic heart disease stands out. Other causes include arterial hypertension and heart valve disease. Diagnosis is made by assessing the likelihood of HF based on medical history, physical examination, and ECG findings. If at least one of the elements is pathological, the next step is to determine natriuretic peptides (BNP, NT proBNP). If BNP values ≥ 35 pg/mL and NT pro BNP ≥ 125 pg/mL, referral to ultrasound (US) of the heart follows. A simple algorithm for diagnosing HF in a family physician’s office is the Male, Infarction, Crepitations, Edema (MICE) algorithm. In the care of a patient suffering from HF, one of the key roles is played by the family doctor, very often being the first doctor to suspect this diagnosis, refer the patient for further diagnostic processing, „take over“ the patient after diagnosis is confirmed by a cardiologist or after hospitalization for acute heart failure. The decision to shift the focus from curative to palliative treatment should be made together by the patient and his family, the family physician, and the cardiologist.
Key words:
diagnosis; family physician; heart failure; palliative care; symptoms; signs; treatment
OGLASI
