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:
  1. Diabetes: Start with ACE inhibitors due to their reno-protective properties.
  2. Heart Failure with Atrial Fibrillation (HF + AF): Consider adding digoxin.

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