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Understanding chronic heart failure
  1. Matthew Fenton,
  2. Michael Burch
  1. Department of Cardiology, Great Ormond Street Hospital, London, UK
  1. Michael Burch, Department of Cardiology, Great Ormond Street Hospital, London, UK; burchm{at}


The key principles of chronic heart failure and the development of clinical management strategies are described. The physiological changes in chronic heart failure and the clinical management of children with heart failure are considered, but the treatment of heart failure related to congenital heart disease or the intensive care management of heart failure are not mentioned as both topics require consideration in their own right. A greater understanding of the maladaptive responses to chronic heart failure has enabled targeted therapy to be introduced with consequent improvement in symptoms, reduction in hospitalisation and lower mortality.

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  • Competing interests: None.

  • Abbreviations:
    ACE inhibitor
    angiotensin-converting-enzyme inhibitor
    B-type natriuretic peptide