HFpEF and CAD Management Algorithm
1. Consider revascularization ...
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Description

HFpEF and CAD Management Algorithm

1. Consider revascularization based on current guidelines for CAD and HFpEF*

2. Statins: all patients unless contraindicated

3. Aspirin: all patients unless contraindicated

4. Clopidogrel (or equivalent antiplatelet): if indicated by current guidelines (eg, recent PCl or ACS)

5. ACE inhibitor: consider in all patients unless contraindicated

6. ARB: if ACE inhibitor contraindicated

7. ß-BIocker: perform exercise testing to evaluate for Cl. If Cl, first consider pacemaker then start vasodilating ß-blocker. If no CI, treat with vasodilating ß-blocker.*

8. Angina: consider ranolazine if angina is not controlled by above medications. Also consider nitrates, calcium channel blockers. *

9. Optimal BP management: if BP is not controlled by ACE inhibitor/ARB + vasodilating ß-blocker, optimize fluid status (hypervolemia may exacerbate hypertension in patients with increased arterial stiffness), add chlorthalidone, consider spironolactone

10. Lifestyle modification: diet, exercise, cardiac rehabilitation, smoking cessation, weight loss (consider bariatric surgery in morbid obesity); treat obstructive sleep apnea

11. Enroll in HFpEF clinical trial



#HFpEF #CAD #Management #Algorithm #cardiology
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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