How should heart failure be treated?

At present, the treatment of heart failure is based on the "guide", and in a word, it is based on the "guide".

How to understand the Guide and how to implement it in our clinic is really a long way to go from abroad to China.

Because all patients with heart failure are a syndrome, and the treatment of each patient with heart failure is individualized.

But in general, for the treatment of heart failure, we emphasize one word, which is called the "golden triangle" of heart failure drug treatment.

"Golden Triangle" drug therapy mainly includes three main aspects of drugs:

One is what we call RAAS system blockers; This mainly includes ACEI drugs, or in the case of intolerance, we can choose ARB drugs, which is a large category;

The second category is what we call beta blockers;

The third category is aldosterone receptor inhibitors.

Only by combining these three treatment methods can the total mortality of heart failure, or its improvement, be better developed, which is one aspect.

In addition, there are some drugs to improve clinical symptoms, and diuretics are the most common in our clinic.

Then diuretics can quickly eliminate congestion in patients' pulmonary circulation, and can also quickly eliminate congestion in our systemic circulation.

Clinically, how to make this patient feel better is what we call dry weight-what is dry weight, that is, the patient's excess water, including systemic and pulmonary circulation, can be discharged-so that the patient can have a better life and a more comfortable state.

This medicine for treating heart failure is developing rapidly.

In fact, there are also some developments in some instruments, such as a three-chamber pacemaker, which we call CRT (cardiac resynchronization therapy).

In fact, according to some studies, resynchronizing the heart in this systolic state can improve the symptoms and long-term prognosis of patients.

In this regard, foreign and domestic countries have also done a lot of research.

Of course, not all patients are suitable for this three-chamber pacemaker, and they all need this resynchronization therapy.

Only some people (suitable for cardiac resynchronization therapy), such as he (has) this kind of cardiomyopathy, he has this kind of conduction block. When his QRS wave is greater than or equal to120ms, at this time, it is considered that this kind of resynchronization therapy, that is, the resynchronization therapy of a three-chamber pacemaker, can make this kind of myocardial synchronization better and improve the function of the heart.

At this time, perhaps we suggest that patients use this treatment.

In addition, for example, after acute myocardial infarction, there is a ventricular aneurysm. At this time, it is necessary to rebuild the patient's blood supply. It is found that ventricular aneurysm is very large, and the resection of ventricular aneurysm and the reconstruction of blood supply, including bypass surgery, are also our common means to treat heart failure.

It has certain requirements, that is, not all patients need this treatment. Only under the guidance of a professional clinician and according to the patient's consultation can further treatment be given to the patient.

Of course, some treatments for patients in the middle and late stages, including some heart transplants and so on. Heart transplantation is actually a primary stage in our country, and many foreign countries have done it. In this regard, we should gradually formulate such a treatment plan according to the patient's situation.

Generally speaking, both CRT and heart transplantation should be carried out on the basis of our standardized drug treatment, not without drugs-the "Golden Triangle" drugs we just talked about are the basis.