Heart Failure Medical Slides

Present each class with its landmark trial, mechanism, and mortality benefit: sacubitril-valsartan (PARADIGM-HF), evidence-based beta-blockers (MERIT-HF, COPERNICUS), mineralocorticoid receptor antagonists (RALES, EMPHASIS-HF), and SGLT2 inhibitors (DAPA-HF, EMPEROR-Reduced). Emphasize the simultaneous initiation strategy over sequential up-titration, which the 2022 AHA/ACC guidelines now endorse.

Start with the diagnostic challenge using the H2FPEF or HFA-PEFF scores, then cover the limited evidence base compared to HFrEF. Highlight SGLT2 inhibitors as the first class with clear mortality and hospitalization benefit in HFpEF (EMPEROR-Preserved, DELIVER), and discuss comorbidity-driven management for hypertension, atrial fibrillation, obesity, and coronary disease.

Use the Nohria-Stevenson hemodynamic profiles (warm-wet, cold-wet, cold-dry, warm-dry) as a visual framework. Map each profile to its initial management strategy: vasodilators and diuretics for warm-wet, inotropes and diuretics for cold-wet, and careful fluid challenge for cold-dry. This gives learners a mental model that links exam findings directly to treatment.