Protocolo de manejo de la insuficiencia cardíaca crónica con fracción de eyección ventricular izquierda reducida

The management of heart failure with reduced ejection fraction (HFrEF) includes lifestyle changes, pharmacological measures, and implantable devices. Pharmacological measures include three drug groups: diuretics aimed at controlling fluid overload and congestive symptoms; drugs with prognostic implications, whose use is practically mandatory and which include four main groups: beta-adrenergic blockers, angiotensin receptor-neprilysin inhibitors, mineralocorticoid antagonists, sodium-glucose cotransporter-2 inhibitors (SGLT2is); and other supportive drugs with less evidence on their indications, which are useful when the above do not achieve symptoms control.