Heart Health

Heart failure care at any ejection fraction

Care that applies at any ejection fraction Always

Recommendationhf-foundationsNo one has reached this rule yet

Daily weights with a call threshold; avoid NSAIDs; cardiac rehab; check iron; stay vaccinated

Clinical review

All reviewers

No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.

What someone who reaches this rule is told

Word for word, as generated for the example person below. Figures in the text are theirs.

  • Strongly recommended

    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) · Class I

  • Not recommended for you

    Avoid ibuprofen, naproxen, and other NSAIDs. Use acetaminophen (paracetamol) for everyday aches instead.

    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.

    Guideline consensusRecommended by the guideline writing committee, drawing on trials plus expert judgement where trials run out.· Class III· checked 2026-09-12

    2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure (Circulation) · Class III (harm) — avoid

  • Strongly recommended

    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training in heart failure improves symptoms, exercise capacity, and quality of life — being told to take it easy is outdated advice.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) · Class I

An example person who reaches it

Heart failure with a weak pump” — an illustrative profile, not a real user.

67-year-old manBP 126/76LDL 105eGFR 58UACR 60 mg/gheart failure, EF 32%10-yr PREVENT-ASCVD 6.4%

Their path through heart failure

  1. Diagnosed heart failure?Yes
  2. Ejection fraction — the number that decides the whole regimen40% or below (reduced)
  3. Care that applies at any ejection fractionAlways ← this rule

Where it sits

Asked after: Heart failure

Sources

Cited by the recommendations above.

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Runs in lib/engine/heartFailurePathway.ts as hf-foundations.