0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Treatment of Acute and Chronic Congestive Heart Failure by Vasodilator-Afterload Reduction

Dean T. Mason, MD; Najam A. Awan, MD; James A. Joye, MD; Garrett Lee, MD; Anthony N. DeMaria, MD; Ezra A. Amsterdam, MD
Arch Intern Med. 1980;140(12):1577-1581. doi:10.1001/archinte.1980.00330230023008.
Text Size: A A A
Published online

Management of congestive heart failure is based on recognition of the specific underlying cardiac disease, understanding of the pathophysiology involved, exclusion of extracardiac complicating factors perpetuating cardiovascular dysfunction, complete information concerning available prophylactic measures, and thorough knowledge of medical and surgical therapy. Although most patients respond favorably to conventional treatment consisting of digitalis and diuretics, relatively refractory heart failure may develop in advanced myocardial heart disease (the specific, idiopathic, and ischemic cardiomyopathies) unamenable to operative intervention. The most important recent advance in the medical therapy for such patients with acute and chronic pump dysfunction has been the application of systemic vasodilator drugs to reduce excessive left ventricular afterload, thereby improving lowered cardiac output and decreasing elevated pulmonary venous pressure.

RATIONALE OF AFTERLOAD REDUCTION THERAPY  The cardiac output delivered from the intact heart is governed by integration of four principal determinants: (1) preload (ventricular end-diastolic volume), (2) contractility (variable force of

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();