wikidoc - Recent changes [en]

Hypertensive crisis

2026-05-11T19:46:32Z

The terminology has been updated from Hypertensive urgency to severe hypertension; the treatment section has been extensively updated in line with the 2025 AHA/ACC HTN Guidelines.

Show changes

User:Fahad Hasan

2026-05-11T14:21:28Z

Articles Authored/Edited

← Older revision		Revision as of 14:21, 11 May 2026
Line 17:		Line 17:
	* [[Hemorrhoids]]		* [[Hemorrhoids]]
	* [[Colorectal Cancer]]		* [[Colorectal Cancer]]
			* [[Pancreatic cancer\|Pancreatic Cancer]]
			* [[Stomach cancer\|Stomach Cancer]]

Congestive heart failure pharmacotherapy

2026-05-10T17:14:19Z

Overview

← Older revision		Revision as of 17:14, 10 May 2026
Line 4:		Line 4:

	== Overview ==		== Overview ==
			Management of heart failure is guided by [[ejection fraction]] phenotype ([[HFrEF]] vs HFmrEF/[[HFpEF]]), clinical stage, congestion status, and underlying etiology, with the goals of improving symptoms, reducing hospitalization, and improving survival. Contemporary care prioritizes rapid initiation and optimization of GDMT (foundational 4-drug therapy in [[HFrEF]]; SGLT2 inhibitor–centered, comorbidity-driven therapy with selective ARNI/[[ARB]]/MRA in HFmrEF/[[HFpEF]]) alongside diuretics for relief of congestion. Longitudinal management requires structured reassessment of symptoms, vitals, renal function/electrolytes, and cardiac function to guide titration, add-on therapies, and candidacy for [[Implantable cardioverter defibrillator\|ICD]]/[[Cardiac resynchronization therapy\|CRT]] or structural interventions, with referral for advanced HF therapies when progression occurs. Effective implementation is strengthened by multidisciplinary HF programs, patient education and lifestyle interventions, and coordinated transitions of care.

	== Management of [[patients]] with heart failure with reduced ejection fraction ([[HFrEF]])==		== Management of [[patients]] with heart failure with reduced ejection fraction ([[HFrEF]])==

Congestive heart failure with preserved EF pharmacotherapy

2026-05-10T16:38:28Z

← Older revision		Revision as of 16:38, 10 May 2026
(2 intermediate revisions by the same user not shown)
Line 49:		Line 49:
	\| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center \|'''Recommedation for patients with NYHA class 2-4 heart failure with mildly reduced ejection fraction		\| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center \|'''Recommedation for patients with NYHA class 2-4 heart failure with mildly reduced ejection fraction
	\|-		\|-
	\|style="font-size: 100; padding: 0 5px; background: #~~B8B8B8~~" align=left \|''' [[Diuretics]] ([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''		\|style="font-size: 100; padding: 0 5px; background: #EDFAED" align=left \|''' [[Diuretics]] ([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''
	\|-		\|-
	\|style="padding: 0 5px; font-size: 100%; background: ~~#F5F5F5~~; width: 70%" align=left\|		\|style="padding: 0 5px; font-size: 100%; background: LightGreen; width: 70%" align=left\|
	❑ [[Diuretics]] are recommended in [[patients]] with [[congestion]] and [[HFmrEF]] in order reduce [[symptoms]] and [[signs]]<br>		❑ [[Diuretics]] are recommended in [[patients]] with [[congestion]] and [[HFmrEF]] in order reduce [[symptoms]] and [[signs]]<br>
	\|-		\|-
	\|style="font-size: 100; padding: 0 5px; background: #~~B8B8B8~~" align=left \|''' [[ACEI]] ([[ESC guidelines classification scheme\|Class IIb, Level of Evidence C]]):'''		\|style="font-size: 100; padding: 0 5px; background: #EDFAED" align=left \|''' [[ACEI]] ([[ESC guidelines classification scheme\|Class IIb, Level of Evidence C]]):'''
	\|-		\|-
	\|style="padding: 0 5px; font-size: 100%; background: ~~#F5F5F5~~; width: 70%" align=left\|		\|style="padding: 0 5px; font-size: 100%; background: LemonChiffon; width: 70%" align=left\|
	❑ [[ACE-I]] may be considered for patients with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>		❑ [[ACE-I]] may be considered for patients with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>
	❑ [[ARB]] may be indicated for [[patients]] with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>		❑ [[ARB]] may be indicated for [[patients]] with [[HFmrEF]] to reduce the risk of [[HF]] hospitalization and death<br>
Line 64:		Line 64:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2021 ESC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 ESC Guideline</small>''<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>
	\|-		\|-
	\|}<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>		\|}


Line 89:		Line 89:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2022 AHA Guideline</small>''<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}

	==[[Heart failure]] With Improved [[Ejection Fraction]] ([[HFimpEF]])==		==[[Heart failure]] With Improved [[Ejection Fraction]] ([[HFimpEF]])==
Line 113:		Line 113:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above tables adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above tables is adopted from 2022 AHA Guideline</small>''
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
Line 169:		Line 169:
	{{familytree/end}}		{{familytree/end}}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above tables adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above tables is adopted from 2022 AHA Guideline</small>''<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}


Line 184:		Line 184:

	\|-		\|-
	\|style="font-size: 100; padding: 0 5px; background: #~~B8B8B8~~" align=left \|'''([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''		\|style="font-size: 100; padding: 0 5px; background: #EDFAED" align=left \|'''([[ESC guidelines classification scheme\|Class I, Level of Evidence C]]):'''
	\|-		\|-
	\|style="padding: 0 5px; font-size: 100%; background: ~~#F5F5F5~~; width: 70%" align=left\|		\|style="padding: 0 5px; font-size: 100%; background: LightGreen; width: 70%" align=left\|
	❑ Screening, treatment, investigation of underlying etiologies, and		❑ Screening, treatment, investigation of underlying etiologies, and
	[[cardiovascular]] and non-[[cardiovascular]] comorbidities is recommended in [[patients]] with [[HFpEF]]<br>		[[cardiovascular]] and non-[[cardiovascular]] comorbidities is recommended in [[patients]] with [[HFpEF]]<br>
Line 192:		Line 192:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2021 ESC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 ESC Guideline</small>''<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>
	\|-		\|-
	\|}<ref name="pmid34447992">{{cite journal \|vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A \|title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure \|journal=Eur Heart J \|volume=42 \|issue=36 \|pages=3599–3726 \|date=September 2021 \|pmid=34447992 \|doi=10.1093/eurheartj/ehab368 \|url=}}</ref>		\|}


Line 243:		Line 243:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above tables adopted from 2022 AHA Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above tables is adopted from 2022 AHA Guideline</small>''<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>
	\|-		\|-
	\|}<ref name="pmid35363500">{{cite journal\| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM \| display-authors=etal\| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. \| journal=Circulation \| year= 2022 \| volume= 145 \| issue= 18 \| pages= e876-e894 \| pmid=35363500 \| doi=10.1161/CIR.0000000000001062 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500 }} </ref>		\|}

	==External Link==		==External Link==

Congestive heart failure chronic pharmacotherapy

2026-05-10T16:24:34Z

Show changes

Congestive heart failure pharmacotherapy

2026-05-10T06:57:07Z

← Older revision		Revision as of 06:57, 10 May 2026
(One intermediate revision by the same user not shown)
Line 31:		Line 31:
	<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]''		<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]''
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''<ref name="pmid35363499">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e895–e1032 \|date=May 2022 \|pmid=35363499 \|doi=10.1161/CIR.0000000000001063 \|url=}}</ref>
	\|-		\|-
	\|}		\|}
Line 52:		Line 52:
	<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''		<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2021 AHA/ACC Guideline</small>''		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2021 AHA/ACC Guideline</small>''<ref name="pmid33446410">{{cite journal \|vauthors=Maddox TM, Januzzi JL, Allen LA, Breathett K, Butler J, Davis LL, Fonarow GC, Ibrahim NE, Lindenfeld J, Masoudi FA, Motiwala SR, Oliveros E, Patterson JH, Walsh MN, Wasserman A, Yancy CW, Youmans QR \|title=2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee \|journal=J Am Coll Cardiol \|volume=77 \|issue=6 \|pages=772–810 \|date=February 2021 \|pmid=33446410 \|doi=10.1016/j.jacc.2020.11.022 \|url=}}</ref>
	\|-		\|-
	\|}		\|}
Line 62:		Line 62:
	<span style="font-size:85%">'''''ARNi:''' [[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''		<span style="font-size:85%">'''''ARNi:''' [[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''<ref name="pmid35363499"></ref>
	\|-		\|-
	\|}		\|}

	==Congestive heart failure treatment summary based on 2021 AHA/ACC Guideline<ref name="~~pmid33755495~~">{{cite journal \|vauthors=Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS \|title=2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure) \|journal=Circ Cardiovasc Qual Outcomes \|volume=14 \|issue=4 \|pages=e000102 \|date=April 2021 \|pmid=33755495 \|pmc=8059763 \|doi=10.1161/HCQ.0000000000000102 \|url=}}</ref>==		==Congestive heart failure treatment summary based on 2021 AHA/ACC Guideline<ref name="pmid33446410"></ref>==
	{\| border="1" cellpadding="2"		{\| border="1" cellpadding="2"
	!width="50"\|Pathophysiology		!width="50"\|Pathophysiology
Line 96:		Line 96:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 AHA/ACC Guideline</small>''		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table is adopted from 2021 AHA/ACC Guideline</small>''<ref name="pmid33446410"></ref>
	\|-		\|-
	\|}		\|}
Line 281:		Line 281:
	{{clear}}		{{clear}}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table adopted from 2021 AHA/ACC Guideline</small>''<ref name="~~pmid33755495~~">{{cite journal \|vauthors=Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS \|title=2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure) \|journal=Circ Cardiovasc Qual Outcomes \|volume=14 \|issue=4 \|pages=e000102 \|date=April 2021 \|pmid=33755495 \|pmc=8059763 \|doi=10.1161/HCQ.0000000000000102 \|url=}}</ref>		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above table adopted from 2021 AHA/ACC Guideline</small>''<ref name="pmid33446410"></ref>

	\|-		\|-

Mitral regurgitation overview

2026-05-10T06:51:29Z

Show changes

Sandbox

2026-05-10T06:45:55Z

← Older revision	Revision as of 06:45, 10 May 2026
(One intermediate revision by the same user not shown)
(No difference)

Congestive heart failure pharmacotherapy

2026-05-10T06:24:48Z

Show changes

Sandbox

2026-05-10T06:01:19Z

← Older revision		Revision as of 06:01, 10 May 2026
(3 intermediate revisions by the same user not shown)
Line 5:		Line 5:

	== Management of [[patients]] with [[heart failure reduced ejection fraction\|heart failure with reduced ejection fraction]] ([[HFrEF]])==		== Management of [[patients]] with [[heart failure reduced ejection fraction\|heart failure with reduced ejection fraction]] ([[HFrEF]])==
	<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]''

	~~===~~ 2022 AHA/ACC/HFSA ~~Guidelines~~ for ~~the Management~~ of ~~Heart Failure ===~~
			The 2022 AHA/ACC/HFSA approach to chronic stage C HFrEF (LVEF ≤40%) emphasizes early initiation of the 4 pillars of guideline-directed medical therapy (GDMT), including ARNI (preferred) or ACEi/ARB, an evidence-based beta-blocker, a MRA in eligible patients, and an SGLT2 inhibitor, alongside diuretics for relief of congestion, with subsequent dose uptitration to target as tolerated. In parallel, patients should be evaluated for device and interventional therapies (e.g., ICD/CRT in appropriate candidates) and referred to an HF specialty team if progressing to advanced/refractory symptoms despite optimized GDMT.

	{{familytree/start \|summary=HFrEF Management Algorithm (2022 AHA/ACC Guidelines)}}		{{familytree/start \|summary=HFrEF Management Algorithm (2022 AHA/ACC Guidelines)}}

Line 29:		Line 30:

	{{familytree/end}}		{{familytree/end}}
			<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]''
			{\|
			! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''
			\|-
			\|}

	===Treatment Algorithm for [[Guideline-Directed Medical Therapy]] Including Novel Therapies===		===Treatment Algorithm for [[Guideline-Directed Medical Therapy]] Including Novel Therapies===

	{{familytree/start}}		{{familytree/start}}
	{{familytree \| \| \| \| \| \| \| \| \| \| A01 \| \| \| \| \| \|A01=[[Heart failure ]] reduced [[EF]], stage C, treatment}}		{{familytree \| \| \| \| \| \| \| \| \| \| A01 \| \| \| \| \| \|A01=[[Heart failure ]] reduced [[EF]], stage C, treatment}}
Line 43:		Line 50:
	{{familytree \| \| G0 \| \| \|G2 \| \| G3\| \| G4 \| \| G5 \| \| \|G0=[[Aldosterone antagonist]]\|G2= [[SGLT2 inhibitor]]\|G3=[[Diuretic]] agents\|G4= [[Hydralazine]] + [[Isosorbide dinitrate]]\|G5=[[Ivabradine]]}}		{{familytree \| \| G0 \| \| \|G2 \| \| G3\| \| G4 \| \| G5 \| \| \|G0=[[Aldosterone antagonist]]\|G2= [[SGLT2 inhibitor]]\|G3=[[Diuretic]] agents\|G4= [[Hydralazine]] + [[Isosorbide dinitrate]]\|G5=[[Ivabradine]]}}
	{{familytree/end}}		{{familytree/end}}
			<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors''
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above algorithm adopted from 2021 AHA/ACC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2021 AHA/ACC Guideline</small>''
	\|-		\|-
	\|}		\|}

	== Management of [[patients]] with [[heart failure with preserved ejection fraction]] ([[HFrEF]])==		== Management of [[patients]] with [[heart failure with preserved ejection fraction]] ([[HFrEF]])==
	~~<span style="font-size:85%">'''Abbreviations:''' '''ARNi:''' [[Angiotensin receptor-neprilysin~~ inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors		HFpEF management in the 2022 AHA/ACC/HFSA framework recommends optimizing comorbidities (especially hypertension), using diuretics for congestion, initiating an SGLT2 inhibitor to reduce HF hospitalizations and CV mortality, and selectively adding MRAs, ARBs, or ARNI to reduce hospitalizations, particularly when LVEF is at the lower end of the preserved range.

	~~=== 2022 AHA/ACC/HFSA Guidelines for the Management of Heart Failure ===~~
	{{familytree/start \|summary=2022 AHA/ACC/HFSA HFpEF Management Algorithm}} {{familytree \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| A01 \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \|A01='''Symptomatic HF'''<br/>LVEF ≥50%}} {{familytree \| \| \| \|,\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|^\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|.\| }} {{familytree \| \| \| B01 \| \| \| \| \| \| \| \| \| \| \| B02 \| \| \| \| \| \| B03 \| \| \| \| \| \| \| \| B04 \| \| \| \| \| \| B05 \| \|B01='''Diuretics,'''<br/>'''as needed'''<br/>(Class I)\|B02='''SGLT2i'''<br/>(Class IIa)\|B03='''ARNi'''<br/>(Class IIb)\|B04='''MRA'''<br/>(Class IIb)\|B05='''ARB'''<br/>(Class IIb)}} {{familytree/end}} <small>Greater benefit in patients with LVEF closer to 50%.</small>		{{familytree/start \|summary=2022 AHA/ACC/HFSA HFpEF Management Algorithm}} {{familytree \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| A01 \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \| \|A01='''Symptomatic HF'''<br/>LVEF ≥50%}} {{familytree \| \| \| \|,\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|^\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|-\|.\| }} {{familytree \| \| \| B01 \| \| \| \| \| \| \| \| \| \| \| B02 \| \| \| \| \| \| B03 \| \| \| \| \| \| \| \| B04 \| \| \| \| \| \| B05 \| \|B01='''Diuretics,'''<br/>'''as needed'''<br/>(Class I)\|B02='''SGLT2i'''<br/>(Class IIa)\|B03='''ARNi'''<br/>(Class IIb)\|B04='''MRA'''<br/>(Class IIb)\|B05='''ARB'''<br/>(Class IIb)}} {{familytree/end}} <small>Greater benefit in patients with LVEF closer to 50%.</small>
			<span style="font-size:85%">'''ARNi:''' [[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors
			{\|
			! colspan="2" style="background: PapayaWhip;" align="center" + \|''<small>The above algorithm is adopted from 2022 AHA/ACC/HFSA Guidelines for Management of Heart Failure</small>''
			\|-
			\|}

	== Congestive heart failure treatment summary based on 2021 AHA/ACC Guideline <ref name="pmid33755495">{{cite journal \|vauthors=Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS \|title=2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure) \|journal=Circ Cardiovasc Qual Outcomes \|volume=14 \|issue=4 \|pages=e000102 \|date=April 2021 \|pmid=33755495 \|pmc=8059763 \|doi=10.1161/HCQ.0000000000000102 \|url=}}</ref> ==		== Congestive heart failure treatment summary based on 2021 AHA/ACC Guideline <ref name="pmid33755495">{{cite journal \|vauthors=Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS \|title=2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure) \|journal=Circ Cardiovasc Qual Outcomes \|volume=14 \|issue=4 \|pages=e000102 \|date=April 2021 \|pmid=33755495 \|pmc=8059763 \|doi=10.1161/HCQ.0000000000000102 \|url=}}</ref> ==
Line 84:		Line 96:
	\|}		\|}
	{\|		{\|
	! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table adopted from 2021 AHA/ACC Guideline		! colspan="2" style="background: PapayaWhip;" align="center" + \|The above table is adopted from 2021 AHA/ACC Guideline
	\|-		\|-
	\|}		\|}

Mitral stenosis overview

2026-05-10T04:24:50Z

Show changes

Sandbox

2026-05-09T14:33:53Z

Management of patients with heart failure with reduced ejection fraction (HFrEF)

← Older revision		Revision as of 14:33, 9 May 2026
Line 5:		Line 5:

	== Management of [[patients]] with [[heart failure reduced ejection fraction\|heart failure with reduced ejection fraction]] ([[HFrEF]])==		== Management of [[patients]] with [[heart failure reduced ejection fraction\|heart failure with reduced ejection fraction]] ([[HFrEF]])==
	<span style="font-size:85%">'''~~Abbreviations:~~''' '''~~ARNi:~~''' [[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]		<span style="font-size:85%">'''''ARNi:''''' ''[[Angiotensin receptor-neprilysin inhibitor\|Angiotensin Receptor-Neprilysin inhibitor]]; '''ACEi:''' [[Angiotensin-converting enzyme inhibitor\|Angiotensin-Converting Enzyme inhibitor]]; '''ARB:''' [[Angiotensin-II receptor blocker\|Angiotensin II Receptor Blocker]]; '''MRA:''' Mineralocorticoid Receptor Antagonist; '''SGLT2i:''' Sodium Glucose Cotransporter 2 inhibitors; '''ICD:''' [[Implantable cardioverter-defibrillator\|Implantable Cardioverter-Defibrillator]]; '''CRT-D:''' [[cardiac resynchronization therapy\|Cardiac Resynchronization Therapy]] with [[Defibrillator]]; '''CRT-P:''' [[ cardiac resynchronization therapy\| Cardiac Resynchronization Therapy]] with [[Pacemaker]]; '''MCS:''' [[Mechanical circulatory support\|Mechanical Circulatory Support]]; '''LVAD:''' [[Left ventricular assist device\|Left Ventricular Assist Device]]''

	=== 2022 AHA/ACC/HFSA Guidelines for the Management of Heart Failure ===		=== 2022 AHA/ACC/HFSA Guidelines for the Management of Heart Failure ===

Aortic regurgitation overview

2026-05-08T23:56:28Z

Overview

Show changes

Aortic stenosis overview

2026-05-08T22:20:25Z

Classification

Show changes

SANDBOX:HT

2026-05-08T13:48:11Z

Blanked the page

Show changes

User:Bezalel Hakkeem

2026-05-07T20:46:21Z

User account Bezalel Hakkeem was created by Joseph Nasr and password was sent by email New Scholar

User:Monish TM

2026-05-07T20:45:18Z

User account Monish TM was created by Joseph Nasr and password was sent by email New Scholar

Heart failure resident survival guide

2026-05-06T22:22:38Z

Show changes

Congestive heart failure Management of Acute heart failure

2026-05-06T22:03:50Z

Show changes

Atrial fibrillation

2026-05-06T21:56:33Z

Show changes

User:Nehal Eid

2026-05-06T21:15:22Z

← Older revision		Revision as of 21:15, 6 May 2026
Line 1:		Line 1:
	[[User:Nehal Eid\|Nehal Eid, M.D.]][mailto:nehalelsaeed98@gmail.com]		[[User:Nehal Eid\|Nehal Eid, M.D.]][mailto:nehalelsaeed98@gmail.com]'''Wikidoc contributions:'''

	'''Wikidoc contributions:'''

	[[Intravenous drug use (recreational)]]		[[Intravenous drug use (recreational)]]
Line 14:		Line 12:

	[[Congestive heart failure Management of Acute heart failure]]		[[Congestive heart failure Management of Acute heart failure]]

			[[atrial fibrillation]]

	[[Sudden cardiac death]]		[[Sudden cardiac death]]

User:Joseph Nasr

2026-05-05T23:59:57Z

Matt Pijoan changed group membership for Joseph Nasr: granted bureaucrat, bureaucrats, interface administrator, nocaptcha and administrator

User:Basir Gill

2026-05-05T23:59:12Z

Matt Pijoan changed group membership for Basir Gill: granted bureaucrat, bureaucrats, interface administrator, nocaptcha and administrator

Thoracic aortic aneurysm surgery

2026-05-05T22:21:13Z

Show changes

Ischemic stroke medical therapy

2026-05-05T16:05:16Z

← Older revision		Revision as of 16:05, 5 May 2026
Line 4:		Line 4:

	==Overview==		==Overview==
	Acute ischemic stroke therapy is primarily directed to rapid reperfusion with intravenous thrombolysis (alteplase or tenecteplase) in eligible patients and endovascular thrombectomy (EVT) in eligible patients with large vessel occlusion (LVO); these treatments should be considered in parallel and should not delay each other.		Acute ischemic stroke therapy is primarily directed to rapid reperfusion with intravenous thrombolysis (alteplase or tenecteplase) in eligible patients and endovascular thrombectomy (EVT) in eligible patients with large vessel occlusion (LVO); these treatments should be considered in parallel and should not delay each other.<ref name="pmid41582814">{{cite journal \|vauthors=Prabhakaran S, Gonzalez NR, Zachrison KS, Adeoye O, Alexandrov AW, Ansari SA, Chapman S, Czap AL, Dumitrascu OM, Ishida K, Jadhav AP, Johnson B, Johnston KC, Khatri P, Kimberly WT, Lee VH, Leslie-Mazwi TM, Mac Grory B, Madsen TE, Menon B, Mistry EA, Park S, Parker S, Pérez de la Ossa N, Reeves M, Saiz T, Scott PA, Schwartzberg D, Sheth SA, Sporns PB, Times S, Tjoumakaris S, Wolfe SQ, Yaghi S \|title=2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association \|journal=Stroke \|volume= \|issue= \|pages= \|date=January 2026 \|pmid=41582814 \|doi=10.1161/STR.0000000000000513 \|url=}}</ref>

	Antiplatelet therapy (usually aspirin) is recommended within 24–48 hours after onset in most patients who are not receiving IV thrombolysis, and is generally delayed until 24 hours after thrombolysis.		Antiplatelet therapy (usually aspirin) is recommended within 24–48 hours after onset in most patients who are not receiving IV thrombolysis, and is generally delayed until 24 hours after thrombolysis.<ref name="pmid41582814">{{cite journal \|vauthors=Prabhakaran S, Gonzalez NR, Zachrison KS, Adeoye O, Alexandrov AW, Ansari SA, Chapman S, Czap AL, Dumitrascu OM, Ishida K, Jadhav AP, Johnson B, Johnston KC, Khatri P, Kimberly WT, Lee VH, Leslie-Mazwi TM, Mac Grory B, Madsen TE, Menon B, Mistry EA, Park S, Parker S, Pérez de la Ossa N, Reeves M, Saiz T, Scott PA, Schwartzberg D, Sheth SA, Sporns PB, Times S, Tjoumakaris S, Wolfe SQ, Yaghi S \|title=2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association \|journal=Stroke \|volume= \|issue= \|pages= \|date=January 2026 \|pmid=41582814 \|doi=10.1161/STR.0000000000000513 \|url=}}</ref>

	Secondary prevention includes antiplatelets or anticoagulation depending on etiology (eg, atrial fibrillation), lipid-lowering therapy, and risk-factor management.		Secondary prevention includes antiplatelets or anticoagulation depending on etiology (eg, atrial fibrillation), lipid-lowering therapy, and risk-factor management.<ref name="pmid41582814">{{cite journal \|vauthors=Prabhakaran S, Gonzalez NR, Zachrison KS, Adeoye O, Alexandrov AW, Ansari SA, Chapman S, Czap AL, Dumitrascu OM, Ishida K, Jadhav AP, Johnson B, Johnston KC, Khatri P, Kimberly WT, Lee VH, Leslie-Mazwi TM, Mac Grory B, Madsen TE, Menon B, Mistry EA, Park S, Parker S, Pérez de la Ossa N, Reeves M, Saiz T, Scott PA, Schwartzberg D, Sheth SA, Sporns PB, Times S, Tjoumakaris S, Wolfe SQ, Yaghi S \|title=2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association \|journal=Stroke \|volume= \|issue= \|pages= \|date=January 2026 \|pmid=41582814 \|doi=10.1161/STR.0000000000000513 \|url=}}</ref>

	==Medical Therapy==		==Medical Therapy==

	*~~The reported cases~~ of ~~treatment for [[~~COVID-~~19]]-associated [[~~stroke~~]] have followed the same guidelines as patients with no [[COVID-19]] infection. The following recommendations are mainly based on the current guidelines of management for~~ stroke ~~of the AHA 2019.~~		*Treatment of COVID-19–associated ischemic stroke generally follows standard acute ischemic stroke pathways.<ref name="pmid41582814">{{cite journal \|vauthors=Prabhakaran S, Gonzalez NR, Zachrison KS, Adeoye O, Alexandrov AW, Ansari SA, Chapman S, Czap AL, Dumitrascu OM, Ishida K, Jadhav AP, Johnson B, Johnston KC, Khatri P, Kimberly WT, Lee VH, Leslie-Mazwi TM, Mac Grory B, Madsen TE, Menon B, Mistry EA, Park S, Parker S, Pérez de la Ossa N, Reeves M, Saiz T, Scott PA, Schwartzberg D, Sheth SA, Sporns PB, Times S, Tjoumakaris S, Wolfe SQ, Yaghi S \|title=2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association \|journal=Stroke \|volume= \|issue= \|pages= \|date=January 2026 \|pmid=41582814 \|doi=10.1161/STR.0000000000000513 \|url=}}</ref>
	*[[Alteplase\|IV alteplase]] is always preferred over mechanical [[thrombectomy]] when there are no contraindications.<ref name="~~SaverGoyal2016~~">{{cite journal\|~~last1=Saver\|first1=Jeffrey L.\|last2=Goyal\|first2=Mayank\|last3=van der Lugt\|first3=Aad\|last4~~=Menon~~\|first4=Bijoy K.\|last5=Majoie\|first5=Charles~~ B~~. L.~~ M.\|~~last6~~=~~Dippel~~\|~~first6~~=~~Diederik W.~~\|~~last7~~=~~Campbell~~\|~~first7~~=~~Bruce C.~~\|~~last8~~=~~Nogueira~~\|~~first8~~=~~Raul G.~~\|~~last9~~=~~Demchuk~~\|~~first9~~=~~Andrew M~~.\|~~last10~~=~~Tomasello\|first10=Alejandro\|last11=Cardona\|first11=Pere\|last12=Devlin\|first12=Thomas G~~.~~\|last13~~=~~Frei~~\|~~first13~~=~~Donald F.\|last14=du Mesnil~~ de ~~Rochemont~~\|~~first14~~=~~Richard\|last15=Berkhemer\|first15=Olvert~~ A.\|~~last16~~=~~Jovin~~\|~~first16=Tudor G.\|last17~~=~~Siddiqui~~\|~~first17~~=~~Adnan H.~~\|~~last18~~=~~van Zwam~~\|~~first18~~=~~Wim H.~~\|~~last19~~=~~Davis~~\|~~first19~~=~~Stephen M~~.~~\|last20=Castaño\|first20=Carlos\|last21=Sapkota\|first21=Biggya L~~.\|~~last22~~=~~Fransen\|first22=Puck S~~.~~\|last23~~=~~Molina~~\|~~first23~~=~~Carlos~~\|~~last24~~=~~van Oostenbrugge~~\|~~first24~~=~~Robert J.~~\|~~last25~~=~~Chamorro~~\|~~first25~~=~~Ángel~~\|~~last26~~=~~Lingsma~~\|~~first26~~=~~Hester~~\|~~last27~~=~~Silver~~\|~~first27~~=~~Frank L~~.\|~~last28~~=~~Donnan~~\|~~first28~~=~~Geoffrey A.~~\|~~last29~~=~~Shuaib~~\|~~first29~~=~~Ashfaq~~\|~~last30~~=~~Brown~~\|~~first30~~=~~Scott~~\|~~last31~~=~~Stouch~~\|~~first31~~=~~Bruce~~\|~~last32~~=~~Mitchell~~\|~~first32~~=~~Peter J~~.\|~~last33~~=~~Davalos\|first33~~=~~Antoni~~\|~~last34~~=~~Roos\|first34=Yvo~~ B~~. W.~~ E. M~~.\|last35=Hill\|first35=Michael D.~~\|title=~~Time to Treatment With Endovascular~~ Thrombectomy ~~and Outcomes From Ischemic~~ Stroke~~: A Meta-analysis~~\|journal=~~JAMA~~\|volume=~~316~~\|issue=12\|~~year~~=~~2016~~\|~~pages~~=~~1279~~\|~~issn~~=~~0098-7484~~\|doi=10.~~1001~~/~~jama.2016.13647~~}}</ref>		*In patients with suspected or confirmed LVO, evaluation for EVT should occur urgently, and IV thrombolysis should be given when eligible without delaying EVT.<ref name="pmid41582814">{{cite journal \|vauthors=Prabhakaran S, Gonzalez NR, Zachrison KS, Adeoye O, Alexandrov AW, Ansari SA, Chapman S, Czap AL, Dumitrascu OM, Ishida K, Jadhav AP, Johnson B, Johnston KC, Khatri P, Kimberly WT, Lee VH, Leslie-Mazwi TM, Mac Grory B, Madsen TE, Menon B, Mistry EA, Park S, Parker S, Pérez de la Ossa N, Reeves M, Saiz T, Scott PA, Schwartzberg D, Sheth SA, Sporns PB, Times S, Tjoumakaris S, Wolfe SQ, Yaghi S \|title=2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association \|journal=Stroke \|volume= \|issue= \|pages= \|date=January 2026 \|pmid=41582814 \|doi=10.1161/STR.0000000000000513 \|url=}}</ref>
			*EVT indications include appropriately selected patients within 0–6 hours, and in selected patients within 6–24 hours based on imaging/clinical criteria; recent randomized trials also support EVT in selected large ischemic core anterior circulation strokes.<ref name="pmid38759664">{{cite journal \|vauthors=Hilkens NA, Casolla B, Leung TW, de Leeuw FE \|title=Stroke \|journal=Lancet \|volume=403 \|issue=10446 \|pages=2820–2836 \|date=June 2024 \|pmid=38759664 \|doi=10.1016/S0140-6736(24)00642-1 \|url=}}</ref> <ref name="pmid38265667">{{cite journal \|vauthors= \|title=Trial of Endovascular Thrombectomy for Large Ischemic Strokes \|journal=N Engl J Med \|volume=390 \|issue=4 \|pages=388 \|date=January 2024 \|pmid=38265667 \|doi=10.1056/NEJMx230009 \|url=}}</ref> <ref name="pmid38718358">{{cite journal \|vauthors=Costalat V, Jovin TG, Albucher JF, Cognard C, Henon H, Nouri N, Gory B, Richard S, Marnat G, Sibon I, Di Maria F, Annan M, Boulouis G, Cardona P, Obadia M, Piotin M, Bourcier R, Guillon B, Godard S, Pasco-Papon A, Eker OF, Cho TH, Turc G, Naggara O, Velasco S, Lamy M, Clarençon F, Alamowitch S, Renu A, Suissa L, Brunel H, Gentric JC, Timsit S, Lamy C, Chivot C, Macian-Montoro F, Mounayer C, Ozkul-Wermester O, Papagiannaki C, Wolff V, Pop R, Ferrier A, Chabert E, Ricolfi F, Béjot Y, Lopez-Cancio E, Vega P, Spelle L, Denier C, Millán M, Arenillas JF, Mazighi M, Houdart E, Del Mar Freijo M, Duhamel A, Sanossian N, Liebeskind DS, Labreuche J, Lapergue B, Arquizan C \|title=Trial of Thrombectomy for Stroke with a Large Infarct of Unrestricted Size \|journal=N Engl J Med \|volume=390 \|issue=18 \|pages=1677–1689 \|date=May 2024 \|pmid=38718358 \|doi=10.1056/NEJMoa2314063 \|url=}}</ref>
	*The usefulness of [[anticoagulants]] such as [[thrombin]] inhibitors ([[dabigatran]]) and [[factor Xa]] inhibitors ([[rivaroxaban]], [[apixaban]], [[edoxaban]]) is not well established in the acute setting of [[stroke]].<ref name="GioiaKate2016">{{cite journal\|last1=Gioia\|first1=Laura C.\|last2=Kate\|first2=Mahesh\|last3=Sivakumar\|first3=Leka\|last4=Hussain\|first4=Dulara\|last5=Kalashyan\|first5=Hayrapet\|last6=Buck\|first6=Brian\|last7=Bussiere\|first7=Miguel\|last8=Jeerakathil\|first8=Thomas\|last9=Shuaib\|first9=Ashfaq\|last10=Emery\|first10=Derek\|last11=Butcher\|first11=Ken\|title=Early Rivaroxaban Use After Cardioembolic Stroke May Not Result in Hemorrhagic Transformation\|journal=Stroke\|volume=47\|issue=7\|year=2016\|pages=1917–1919\|issn=0039-2499\|doi=10.1161/STROKEAHA.116.013491}}</ref>		*The usefulness of [[anticoagulants]] such as [[thrombin]] inhibitors ([[dabigatran]]) and [[factor Xa]] inhibitors ([[rivaroxaban]], [[apixaban]], [[edoxaban]]) is not well established in the acute setting of [[stroke]].<ref name="GioiaKate2016">{{cite journal\|last1=Gioia\|first1=Laura C.\|last2=Kate\|first2=Mahesh\|last3=Sivakumar\|first3=Leka\|last4=Hussain\|first4=Dulara\|last5=Kalashyan\|first5=Hayrapet\|last6=Buck\|first6=Brian\|last7=Bussiere\|first7=Miguel\|last8=Jeerakathil\|first8=Thomas\|last9=Shuaib\|first9=Ashfaq\|last10=Emery\|first10=Derek\|last11=Butcher\|first11=Ken\|title=Early Rivaroxaban Use After Cardioembolic Stroke May Not Result in Hemorrhagic Transformation\|journal=Stroke\|volume=47\|issue=7\|year=2016\|pages=1917–1919\|issn=0039-2499\|doi=10.1161/STROKEAHA.116.013491}}</ref>
	*The use of [[thrombolysis]] via ultrasound waves concomitant to [[Fibrinolysis\|IV fibrinolysis]] is not recommended.<ref name="NacuKvistad2017">{{cite journal\|last1=Nacu\|first1=Aliona\|last2=Kvistad\|first2=Christopher E.\|last3=Naess\|first3=Halvor\|last4=Øygarden\|first4=Halvor\|last5=Logallo\|first5=Nicola\|last6=Assmus\|first6=Jörg\|last7=Waje-Andreassen\|first7=Ulrike\|last8=Kurz\|first8=Kathinka D.\|last9=Neckelmann\|first9=Gesche\|last10=Thomassen\|first10=Lars\|title=NOR-SASS (Norwegian Sonothrombolysis in Acute Stroke Study)\|journal=Stroke\|volume=48\|issue=2\|year=2017\|pages=335–341\|issn=0039-2499\|doi=10.1161/STROKEAHA.116.014644}}</ref>		*The use of [[thrombolysis]] via ultrasound waves concomitant to [[Fibrinolysis\|IV fibrinolysis]] is not recommended.<ref name="NacuKvistad2017">{{cite journal\|last1=Nacu\|first1=Aliona\|last2=Kvistad\|first2=Christopher E.\|last3=Naess\|first3=Halvor\|last4=Øygarden\|first4=Halvor\|last5=Logallo\|first5=Nicola\|last6=Assmus\|first6=Jörg\|last7=Waje-Andreassen\|first7=Ulrike\|last8=Kurz\|first8=Kathinka D.\|last9=Neckelmann\|first9=Gesche\|last10=Thomassen\|first10=Lars\|title=NOR-SASS (Norwegian Sonothrombolysis in Acute Stroke Study)\|journal=Stroke\|volume=48\|issue=2\|year=2017\|pages=335–341\|issn=0039-2499\|doi=10.1161/STROKEAHA.116.014644}}</ref>

SANDBOX:HT

2026-05-05T01:55:26Z

Show changes