TREATMENT PLAN
TREATMENT PLAN
- General measures for all:
- Consider statin & anti-platelet
- Manage comorbidities
- Mental health screening
- Supervised exercise programs
- Vaccinations
- Self-care advice
- Appropriate follow-up
- Assess nutritional status
- Childbearing-aged women are advised on pregnancy and contraception – Sick day rules (SADMAN):
- SGLT2 inhibitors
- ACE inhibitors
- Diuretics
- Metformin
- ARBs
- NSAIDs
- Normal Ejection Fraction (>50%):
– Low to medium dose diuretic for symptomatic treatment (max 80mg Furosemide) – Consider specialist input if there is no response to treatment (they may consider cardioprotective – SGLT-2)
- Mild (41-49%):
- Diuretics: furosemide 20-40mg (max 80mg)
- ACE inhibitors/ARBs + B-blockers
- Mineralocorticoid receptor antagonist (spironolactone) if ACE/ARB or B-blocker is not enough
Consider specialist input if there is no response to treatment (they may consider cardioprotective – SGLT-2)
- Reduced Ejection Fraction (<40%)
- Diuretics: furosemide 20-40mg (max 80mg)
- ACE inhibitors/ARBs + B-blockers
- Mineralocorticoid receptor antagonist (spironolactone) if ACE/ARB or B-blocker is not enough
- Consider specialist input if there is no response to treatment (they may consider cardioprotective – SGLT-2)
Specialist options:
- Valsartan if EF <35% (this replaces ACEi)
- Ivabradine if EF <35% and HR >75
- SGLT2 inhibitors: cardioprotective
- Digoxin