Working with a Cardiologist
Occasions arise when a cardiologistís expertise will change the diagnosis or theraptic approach. Consultation or referral to a cardiologist or HF specialty clinic should be considered for patients when the diagnosis is unclear, for patients who remain symptomatic on standard HF therapy, who have underlying valvular, pericardial, or infiltrative disease, or who have potentially reversible ischemic heart disease.
Patients may also benefit from comanagement with a cardiologist to assist with reaching target doses of an ACE inhibitor or initiating additional medications when such additions have proved difficult (beta-blocker). Cardiology consultation should be considered for those with symptomatic atrial or ventricular tachyarrhythmias. In general, antiarrhythmic drugs should be avoided in HF patients because of their increased risk for causing sudden death. The primary care physician should also be considering
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