Care that applies at any ejection fraction Always
hf-foundationsNo one has reached this rule yetDaily weights with a call threshold; avoid NSAIDs; cardiac rehab; check iron; stay vaccinated
No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.
Word for word, as generated for the example person below. Figures in the text are theirs.
Weigh yourself every morning, same time, after the bathroom and before breakfast. A jump of 3 lb in a day or 5 lb in a week means call — don't wait for your next appointment.
Weight gain from fluid shows up days before you feel breathless, and that window is when a phone call and a temporary diuretic adjustment can prevent a hospital admission. This is the single most useful thing you can do at home with heart failure, and it costs nothing but a scale and thirty seconds.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure (Circulation)
Avoid ibuprofen, naproxen, and other NSAIDs. Use acetaminophen (paracetamol) for everyday aches instead.
Expert guidelinesOfficial guidelines recommend it, based on trials plus expert judgment.
NSAIDs make the body retain salt and water, blunt the effect of diuretics and ACE inhibitors, and are a recognized trigger for heart failure decompensation. They're sold over the counter, which is exactly why this gets missed — check cold and flu combination products too, since many contain ibuprofen.
ACC/AHA (US)
Avoid ibuprofen, naproxen, and other NSAIDs.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure (Cir… · Recommendation behind this rule · class and level carried over from an earlier review, not yet re-read against the tables
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure (Circulation) · Class III
Ask for a referral to cardiac rehab, and ask to have your iron checked (ferritin and transferrin saturation).
Supervised exercise training in heart failure improves symptoms, exercise capacity, and quality of life — being told to take it easy is outdated advice. Separately, iron deficiency is common in heart failure and causes fatigue and breathlessness even when you're not anemic; intravenous iron improves symptoms and exercise capacity. Neither gets offered reliably, so both are worth asking for by name. Staying current on flu, COVID, RSV, and pneumococcal vaccines also matters more here than for most people, because a respiratory infection is a common trigger for decompensation.
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure (Circulation)
“Heart failure with a weak pump” — an illustrative profile, not a real user.
Asked after: Heart failure
Cited by the recommendations above.
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Runs in lib/engine/heartFailurePathway.ts as hf-foundations.