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
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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
DOI
10.7603/s40602-014-0012-2
Online ISSN
2315-4551
Publisher
Publisher
ASEAN Federation of Cardiology
Additional Links
Keywords
>> About The AHJ
Topics
Cardiology
Topics
Keywords
Heart Failure
Left Ventricular Ejection Fraction
Acute Myocardial Infarction
Chronic Heart Failure
Clinical Practice Guideline
Author Affiliations
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:
Correspondence to:
Jeyamalar Rajadurai,rjeyacardio@gmail.com
Open Access
This content is freely available to anyone, anywhere at any time.