ABC de la insuficiencia cardiaca

Heart failure (HF) is a highly prevalent syndrome. In Spain the prevalence is 7-8%, representing a substantial healthcare burden and one of the most frequent diagnoses in internal medicine. The major causes of HF are hypertensive heart disease, dilated cardiomyopathy and high blood pressure. These causes vary in importance depending on the population studied. Because the signs and symptoms of HF are non-specific, clinical diagnosis is not easy. Several clinical diagnostic criteria are available for better standardization, the most widely used being the Framingham criteria. All patients with HF should undergo echocardiography. Determination of B-type natriuretic peptide (BNP) (or pro-BNP) is an important diagnostic aid. Mortality is high, between 40% and 50% at 5 years. The availability of angiotensin converting-enzyme inhibitors and beta blockers (to be used in all patients without contraindications) has represented a huge advance in the treatment of this syndrome. However, many of these patients will be treated in the final stage of their disease and will require a more palliative than curative approach.