Volume 70 Number 4 September 2003	back to contents

¹Internal Medicine Resident and ²Assistant Professor of Medicine, Transplant Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY.

Some of the information was adapted from a Grand Rounds presentation to the Division of Cardiology, Mount Sinai School of Medicine, New York, NY on June 12, 2000 and updated July 2002.

Address all correspondence to David A. Baran, M.D., Zena and Michael A. Wiener Cardiovascular Institute, Box 1030,
Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029; Email: David.Baran@mountsinai.org.

Dr. Baran has given six sponsored lectures in the past two years for Glaxo Smith Kline, which markets carvedilol. He
received an honorarium for each lecture. The total received did not exceed the amount allowed by the policy of The Mount Sinai School of Medicine.

ABSTRACT

Heart failure is a common medical condition affecting nearly 5 million people each year in the United States, of whom 500,000 are newly diagnosed. The impact of this disease on society and the health care system is immense. Inpatient and outpatient costs are approximately $40 billion annually, almost $500 million of which is spent on heart failure medications alone. Beyond the problem of financial costs, however, it is imperative for us as health care professionals to improve our ability to prevent disease progression, decrease morbidity and mortality, and optimize patients’ quality of life.
The use of a broad spectrum of treatments is reviewed in the context of a patient case study. Primary data justifying the use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, diuretics, digoxin, as well as beta blockers and spironolactone, is reviewed, with special reference to the stage of heart failure.

KEY WORD

Congestive heart failure, heart failure, treatment, guidelines, case study.

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