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Exertional Dyspnea in Congestive Heart Failure : Living Longer and Doing More?

Darryl Y. Sue, MD, FCCP
Author and Funding Information

Affiliations: Torrance, CA 
 ,  Dr. Sue is Professor of Medicine, UCLA School of Medicine, Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine, Harbor-UCLA Medical Center.

Correspondence to: Darryl Y. Sue, MD, FCCP, Department of Medicine, Box 400, Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA 90509; e-mail: sue@humc.edu



Chest. 2000;118(1):5-7. doi:10.1378/chest.118.1.5
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The management of patients with advanced congestive heart failure has undergone a remarkable transformation in the last 20 years, and we have become accustomed to aggressive pharmacologic treatment with classes of drugs that would previously have been thought to be useless, irrational, or contraindicated. We administer and titrate vasodilators for afterload reduction, we prescribe β-adrenergic blockers and diuretics, and we have the satisfaction of seeing improved outcomes even in patients with very severe heart failure. Indeed, even our understanding of the potential mechanisms of how these drugs can improve survival has altered, changing from how the limited cardiac output can best be distributed to how the damaged myocardium can be protected, preserved, and, potentially, allowed to recover.

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