Alfonso Valle Profile picture
Aug 27, 2021 10 tweets 7 min read Read on X
🧵🔟Tweets sobre los cambios de las nuevas guías #IC @escardio

1️⃣Definición y diagnóstico IC
📌ICrEF: FEVI< 40%
📌IC con FEVI ligeramente reducida. 40-49%
📌IC preservada: FEVI>50%

👉Diagnóstico IC: TAC IIa en baja intermedia probabilidad EAC
#ESCCongress @secardiologia ImageImage
2️⃣ICrFEVI(1)
👉Cuatriterapia a todos los pacientes
👉BB,ARM,iSGLT2 indicación IA
👉ARNI para ⤵️🏥IC y ☠️sobre IECA. Indicación IB (PARADIGM-HF)
👉DAPA/EMPA efecto de clase
#ESCCongress @secardiologia
👉#VERICIGUAT en 👥 con 💊óptimo y nueva 🏥(IIb-B) ImageImage
3️⃣ICrEF durante 🏥
👉siempre optimiza o intenta optimizar 💊
👉valora congestión, excluye signos de congestión persistente
👉asegura transición al alta = 1-2sem el 👥 tiene que ser reevaluado
👉estudia metabolismo del Fe Image
4️⃣ICrFEVI- comorbilidades
👉en todo 👥con DM y riesgo CV usa cualquier iSGLT2 para prevenir 🏥IC, ☠️CV, eventos CV, y progresión de la ERC
👉cardiooncologia indicación I-C
👉IC y FA ▶️ ACODs,
👉CABG primera opción de revascularizacion sobre todo en DM y enf multivaso ImageImage
5️⃣ ICrFEVI- comorbilidades
👉EAo Severa TAVI o SAVR via Heart team
👉Ferropenia:
-evaluación periódica
-Fe IV en 👥IC sintomática con 🏥previo y FEVI<50% con Fe <100ng/dl o ferritina 100-299 o ISAT<20% Image
6️⃣ ICmrEF ó ahora IC con FEVI ligeramente reducida
👉FEVI 40-49%
👉IECA/ARNI, BB, ARM con el mismo nivel de evidencia IIb-C
ICpEF Image
7️⃣ 👉sin datos de #EMPEROR-R
👉diuréticos si paciente congestivo Image
8️⃣ Dispositivos
👉indicación de DAI: NYHA II-III no isquemico FEVI<35% 3m TMO💊 indicación IIa (previo I)
👉indicación de TRC QRS130-149ms y BCRIHH, FEVI<35% & TMO Image
9️⃣ ICA
👉Algoritmo CHAMPIT
👉Fenotipos con manejo específico: EAP;IC derecha; shock cardiogenico; IC agudizada ImageImageImage
🔟Gestión IC
👉equipo multidisciplinar
👉continuidad asistencial: 2sem tras ingreso
👉Monitorización remota para ⤵️🏥 y ☠️CV
👉Rehabilitación cardiaca a TODOS los 👥IC indicación IA
👉Vacunación gripe/neumococo ImageImageImageImage

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More from @ValleAlfonso

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Read 11 tweets

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