Management of Congestive Heart Failure (CHF):
- Diuretics (e.g., furosemide): For symptomatic relief and to reduce volume overload.
- ACE inhibitors (e.g., ramipril): First-line treatment to reduce symptoms and improve survival, particularly beneficial for diabetic patients.
- Beta-blockers: Added to the regimen if symptoms persist after initiating ACE inhibitors.
- Spironolactone: Added if symptoms persist despite optimal doses of ACE inhibitors (or ARBs) and beta-blockers.
- Special Considerations:
- Diabetes: Start with ACE inhibitors due to their reno-protective properties.
- Heart Failure with Atrial Fibrillation (HF + AF): Consider adding digoxin.