Heart Failure with Preserved Ejection Fraction: Management Principles


General Therapeutic Principles:
Reduce the congestive state 
 - Caution to not reduce preload excessively 
Control blood pressure 
 - Central aortic blood pressure control may be more relevant 
Maintain atrial contraction and prevent tachycardia 
 - Efforts to maintain sinus rhythm in atrial fibrilation may be beneficial 
Treat and prevent myocardial ischemia 
 - May mimic HF as an "angina equivalent" 
Detect and treat sleep apnea 
 - Common co-morbidity causing systemic hypertension, pulmonary 

hypertension and right heart dysfunction (adaptive servo-ventilation 

ineffective) 


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