Management of heart failure in patients with normal versus reduced systolic function

To determine how physicians manage heart failure patients with normal left ventricular systolic function, we assessed questionnaire responses from 684 physicians. Overall, 66%, 53%, and 34% obtain resting electrocardiograms, chest x-ray, and echocardiography, respectively, in patients with normal function, versus 75%, 66%, and 41% in patients with decreased function. Beta blocking agents and calcium antagonists are prescribed for patients with normal function. For those with decreased function, digitalis, angiotensin- converting enzyme inhibitors, and dietary sodium and physical activity restriction are used.