Heart Failure

• Laboratory tests: BNP or NT-proBNP, CBC, renal/liver function, troponin, TSH
• Echocardiography: Essential for assessing LVEF and cardiac structure
• Cardiac MRI/CT: For myocardial characterization and infiltrative cardiomyopathy
• Right heart catheterization: For hemodynamic monitoring in advanced HF
• Genetic testing: In selected patients with suspected inherited cardiomyopathy

• Stage A: At-risk (HTN, DM, CAD)
• Stage B: Structural disease without symptoms
• Stage C: Symptomatic HF
• Stage D: Refractory HF needing advanced therapy (e.g., LVAD, HTx)

For HFrEF:

• ACE inhibitors / ARBs / ARNI
• Beta-blockers (e.g., carvedilol, bisoprolol)
• Mineralocorticoid receptor antagonists (MRAs)
• SGLT2 inhibitors (e.g., dapagliflozin, empagliflozin)

Add-on therapies:

• Ivabradine (for HR ≥70 bpm)
• Vericiguat
• Hydralazine/nitrates (in specific populations)
• Omecamtiv mecarbil

Device therapy:

• Implantable cardioverter-defibrillator (ICD)
• Cardiac resynchronization therapy (CRT)

For HFpEF & HFmrEF:

• Symptom control with diuretics
• SGLT2 inhibitors
• Risk factor and comorbidity management

Advanced HF:

• Left Ventricular Assist Device (LVAD)
• Heart transplantation

• Vaccination (e.g., influenza, pneumococcus)
• Iron supplementation if deficient
• Treatment of anemia and sleep apnea
• Nutritional and psychosocial support

• Cardiac rehabilitation
• Remote monitoring and nurse-led HF clinics
• Lifestyle optimization