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Chronic Heart Failure (Other Considerations (Monitoring (BP: may be v. low…

- - - - Valve disease
        Arrhythmias
        Ischaemia
    - - Anaemia
        Infection
        ↑BP
- - - - 3rd line
        
        Digoxin
        
        Cardiac resynchronisation therapy ± ICD
      - Spironolactone / eplerenone
        Watch K carefully (on ACEi too…)
      - ACEi + ARB
      - Vasodilators: hydralazine + ISDN
        Additional Rx in Blacks
    - - Start low, go slow
      - E.g. carvedilol 3.125mg/12h → 25-50mg/24h
      - Wait ≥2wks between increments
      - Switch stable pts taking a β-B for a comorbidity to
        a β-B licensed for heart failure
      - β-B therapy may be particularly good in COPD