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→Congestive Heart Failure
=Congestive Heart Failure=
=Congestive Heart Failure=
* Systolic Dysfunction/HFrEF
* Systolic Dysfunction/HFrEF
** H&P: History of CAD, hypertension, valvular disease, dilated cardiomyopathy (EtOH, Chagas, Coxsackie B), or MI. Dyspnea, PND, orthopnea, cough, hemoptysis, fatigue; S3, displaced PMI, crackles, signs of right heart failure (S4, JVD, edema)
** Dx: LVEF < 40%, enlarged cardiomediastinal silhouette on CXR, elevated BNP
** Tx: ACEI/ARBs, ARNIs, β blockers, SGLT2 inhibitors, Spironolactone, and LVAD all have mortality benefit; Digoxin and diuretics don't have any mortality benefit but help with symptoms and decrease hospitalizations. For acute exacerbations use LMNOP (lasix, morphine, nitrates, oxygen, positioning).
* Non-systolic Dysfunction/HFpEF
* Non-systolic Dysfunction/HFpEF
** H&P: History of amyloidosis, sarcoidosis, hemochromatosis, or radiation leading to infiltrative or restrictive cardiomyopathy.
** Dx: LVEF > 40%
** Tx: SGLT2 inhibitors
=Cardiomyopathy=
=Cardiomyopathy=