The Treatment of Congestive Heart Failure

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FOR purposes of practical therapeutics, congestive heart failure can be divided into two types. In the more common of these, decompensation is the result of intrinsic myocardial disease. For all cases of this kind treatment is the same regardless of underlying etiology. In the less common form, failure is due, not to primary myocardial damage, but to some systemic disease or local pathologic disorder which either increases the demands on the heart for work or interferes with the ability of the myocardium to maintain adequate circulation. Examples of this form of decompensation are cases due to thyrotoxicosis, myxedema, beriberi, severe anemia, arteriovenous aneurysm, patent ductus arteriosus, coarctation of the aorta and chronic constrictive pericarditis. In this group treatment by the measures employed in the common form of failure is of no lasting value. A satisfactory result depends on the medical or surgical correction of the causative condition, and a number of notable advances have been made along this line within the past several years. Parallel with this progress, intensive research on the pathologic physiology of the common type of decompensation has resulted in important changes in therapy. Today, as a result, most persons suffering from an initial attack of the common form of failure can be restored to a comfortable and useful state of health and often can be maintained in this condition for many years by careful supervision of activities, diet, medication and living habits. Treatment of the more common type of congestive failure will be the subject of. . .



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