Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions


Answer 2
  1. Digoxin significantly improves survival of patients with CHF. Digoxin improves symptoms, quality of life, and functional capacity in patients with mild to moderate CHF, regardless of underlying rhythm, but it does not improve patient survival. Although diuretic use is the only means of enabling salt and water excretion in patients with CHF, these drugs should always be used in conjunction with other agents, usually angiotensin-converting enzyme (ACE) inhibitors and beta-blockers. ACE inhibitors are useful in managing left ventricular systolic dysfunction with or without symptoms of CHF; they favorably affect remodeling and survival. The benefits from a hydralazine-nitrate combination may result from biochemical, antioxidant, and/or vasodilatory effects. However, the 2 drugs are not first-line treatments prior to the use of ACE inhibitors. Because of the risk of death and lack of efficacy data, intravenous infusion of positive inotropic agents is not recommended for outpatients.

     Consensus recommendations for the management of chronic heart failure. On behalf of the membership of the advisory council to improve outcomes nationwide in heart failure. Am J Cardiol 1999;83:1A-38A.
    2. Gomberg-Maitland M, Baran DA, Fuster V. Treatment of congestive heart failure: guidelines for the primary care physician and the heart failure specialist. Arch Intern Med 2001;161:342-52.
    3. Heart failure. In: Arky RA, Kettyle WM, Hatem CJ, editors. MKSAP 12: Cardiovascular medicine. Philadelphia: American College of Physicians - American Society of Internal Medicine; 2001:38-49.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj