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. 2011 Nov;7(4):245–249. doi: 10.2174/157340311799960681

Table 2.

ACC/AHA Guidelines for the Management of Heart Failure

Stage A Stage B Stage C Stage D
Patients at high risk without structural disease or symptoms of HF structural heart disease but without symptoms Structural heart disease with prior or current symptoms Refractory HF
Patients examples
 

  •  HTN

  •  DM

  •  CAD

  •   Metabolic syndrome

  •   Obesity

  •   Familial CM

  •   Previous MI

  •   LV remodeling (LVH or low EF)

  •   Valvular disease

  •   Shortness of breath

  •   Fatigue

  •   Reduced exercise tolerance

  •   Marked symptoms at rest despite maximal therapy

Management

  •   Treat HTN, lipid disorders and DM

  •   Life style modifications

  •   ACEI or ARB in appropriate patients

  •   ACEI or ARB

  •   BB

  •   Devices in selected patients

  •   Diuretics for fluid retention

  •   ACEI

  •   BB

  •   Aldosterone antagonist

  •   ARB

  •   Digitalis

  •   Hydralazine/nitrates

  •   Biventricular pacing

  •   Implantable defibrillators

  •   OHT

  •   Chronic inotropes

  •   Permanent mechanical support

  •   End of life care/hospice