Consensus heart failure. Centraal Begeleidingsorgaan voor de Intercollegiale Toetsing

Consensus heart failure--On June 17th, 1994, a consensus meeting was organised to establish guidelines for the diagnosis and treatment of heart failure. Reason to do this were controversies, especially among general practitioners, cardiologists, internists and gerontologists, which arise as a consequence of new diagnostic modalities (such as echocardiography) and altered aims of the treatment (besides relief of symptoms reduction of morbidity and mortality). A number of starting points were formulated by a preparatory committee: Heart failure constitutes a major health problem. It is defined by cardiac dysfunction with accompanying symptoms. Diagnosis and treatment should focus first on causes or contributing factors. The extent of diagnostic procedures depends on possible doubts with regard to diagnosis and aetiology and therapeutic consequences. Treatment should include non-medical measures. Apart from relief of symptoms, the choice of drugs is also determined by their potential to reduce morbidity and mortality. The pharmacotherapeutic approach has to be tailored to the needs of the patient with a central role for the ACE inhibitors. Patients with concomitant arrhythmias and (very) old patients form separate risk groups. Further attention should be paid to the prevention of heart failure.