Furosemida y espironolactona en el tratamiento de insuficiencia cardíaca aguda y crónica

Abstract

Introduction: Heart failure (HF) is considered when there is a structural or functional damage that hinders the correct functioning of the heart. One of the main pillars in its treatment are diuretics, among the most used are furosemide and spironolactone, so it is important to know its effectiveness in the clinical management of HF. Objective: To establish the correct use of furosemide and spironolactone and assess its efficacy for the correct application in daily clinical practice in patients with acute and chronic heart failure. Material and Methods: a descriptive and retrospective study was carried out, where information obtained from the Journal of the American College of Cardiology and pubmed articles of the last 5 years was collected. Results: In the treatment of acute heart failure, furosemide remains a fundamental pillar. Currently there is an alternative route of administration that is the subcutaneous route that has the same efficacy against the intravenous route. In the management of chronic heart failure, the use of spironolactone is indicated in patients with LVEF <35%. Discussion and Conclusion: the use of furosemide in the management of acute HF continues to have evidence 1B; the subcutaneous route of administration merits further investigation since the sample in the studies carried out is small. In the management of chronic HF, low doses of furosemide are recommended and if LVEF is <35%, add spironolactone, since it reduces long-term mortality.