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The diagnosis and management of heart failure (HF) often calls for cooperation between primary and specialist care. Echocardiography should be performed to obtain information about the underlying cause of HF, its mechanism and severity. In principle, echocardiography is indicated for all patients who are going to start long-term medication to manage the condition. Patients with HF often have several coexisting conditions, which might complicate diagnosis and treatment. The aim should always be to target the underlying cause(s), e.g. hypertension, myocardial ischaemia, valvular disease or arrhythmia. All contributing diseases and conditions should also be identified and treated. The most important drug groups in secondary prevention, as far as prognosis and symptoms are concerned, are ACE inhibitors , angiotensin-II receptor antagonists (also known as angiotensin receptor blockers, i.e. ARBs) and beta-blockers, which are used in an asymptomatic phase and also in high-risk patients. Drug treatment to optimise the symptoms and prognosis requires close monitoring of the patient and will take several months.
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