ASEAN Heart Journal

Intended for healthcare professional

Original Paper

ASEAN Heart Journal

May 2014, 22:13

First online: 05 August 2014

Original Paper

Malaysia CPG for Heart Failure

Jeyamalar Rajadurai,1 David Chew,2 Hasri Samion,2 Kannan Pasamanickam,1 Mohd Rahal Yusoff,3 Nik Mazlina binti Mohammad,4 Robaayah Zambahari,2 Sim Kui Hian,5 Sree Raman,6 Wan Azman Wan Ahmad7
Open Access
This content is freely available to anyone, anywhere at any time.
  • Summary
  • Supplementary Material
  • References
  • About this Article

Summary

  • Heart Failure (HF) is a clinical diagnosis. To satisfy the definition of HF, symptoms, signs and/or objective evidence of cardiac dysfunction must be present. (Fig. 1)​
  • HF may be the result of any disorder of the endocardium, myocardium, pericardium or great vessels although commonly, it is due to myocardial dysfunction. It may occur in the presence of reduced left ventricular (LV) function, the left ventricular ejection fraction (LVEF) <40% (HFrEF) or with normal LV function, the LVEF > 50% (HF with with preserved LV function -HFpEF). If the LVEF is 41-49% it is called HFpEF, borderline.
  • It may be classified as Acute HF or chronic HF depending on the acuteness of the clinical presentation.
  • HF is not a complete diagnosis. It is important to identify the underlying disease and the precipitating cause(s), if present. Common causes are coronary artery disease and hypertension. Patients with Chronic HF may occasionally develop acute decompensation. Important causes that can lead to this Acute HF include acute myocardial infarction/ myocardial ischemia, arrhythmias (e.g. atrial fi brillation) and uncontrolled Blood Pressure. (Fig. 2)
  • Prevention and early intervention wherever appropriate, should be the primary objective of management. (Fig. 3)
  • Management of HFrEF (both Acute HF and Chronic HF) and grades of recommendations are as outlined in Flow Charts 1 & 2 and Tables 1 & 2.
  • Management of HFpEF remains empiric since trial data are limited.
  • Non pharmacological measures includes counseling the patient and family about the disease, diet and fl uid intake, regular exercise and appropriate lifestyle changes such as smoking cessation and abstinence from alcohol.
  • HF in pregnancy and in children are best managed in tertiary centres.
  • Performance measures should be instituted to assess quality of care.

Keywords

Heart Failure - Left Ventricular Ejection Fraction - Acute Myocardial Infarction - Chronic Heart Failure - Clinical Practice Guideline


Open Access: This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

Supplementary Material

Nil

References

 

About this Article

Title
Malaysia CPG for Heart Failure


Open Access
Available under Open Access


Journal >> 22:1


Online Date
21 November 2019


DOI
10.7603/s40602-014-0012-2


Online ISSN
2315-4551


Publisher
ASEAN Federation of Cardiology


Additional Links Cardiology


Keywords
Heart Failure
Left Ventricular Ejection Fraction
Acute Myocardial Infarction
Chronic Heart Failure
Clinical Practice Guideline


Author Affiliations
1. Subang Jaya Medical Center, Selangor, Malaysia
2. National Heart Institute Kuala Lumpur, Kuala Lumpur, Malaysia
3. Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
4. Primary Health Clinic Kajang, Kajang, Malaysia
5. Sarawak General Hospital Heart Centre, Sarawak, Malaysia
6. Tuanku Ja’afar Hospital Seremban, Negeri Sembilan, Malaysia
7. University Malaya Medical Centre, Kuala Lumpur, Malaysia


Correspondence to:
Jeyamalar Rajadurai,[email protected]
Open Access
This content is freely available to anyone, anywhere at any time.