Diagnose und medikamentöse Therapie der chronischen Herzinsuffizienz in der hausärztlichen Praxis

Heart failure (HF) is an important clinical syndrome in outpatient and inpatient care with treatment costs accounting for approximately 2% of all health care expenditures in Germany. Since many symptoms of HF are nonspecific, the initial diagnosis is often made in consultations with family practitioners. A diagnostic algorithm for the low prevalence patient population of family practice is based on the National Treatment Guideline “Chronic Heart Failure” (NVL-HF). It takes into account clinical signs and symptoms as well as risk factors to aid decisions on further laboratory diagnostics (NT-pro-BNP) and/or echocardiography. Guideline-directed medical therapy after diagnosis of HI is based on the reduction in left ventricular ejection fraction and NYHA stages. It consists of prognostic agents and an additive diuretic therapy to attenuate symptoms of volume overload.