[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-563393-105":53,"doc-detail-563393-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","management-of-the-heart-failure-patient-in-the-primary-care-setting","Management of the heart failure patient in the primary care setting","","Article presents guidance for managing heart failure patients in primary care, using a case-based approach and clinical framing. It defines heart failure, outlines relevant epidemiology and key risk factors in Singapore, and describes common presentation signs requiring prompt referral. It details post-diagnosis community follow-up, patient self-care goals including salt and fluid restriction, smoking and alcohol avoidance, symptom surveillance, weight monitoring, early intervention for decompensation, and support for work-related functional changes.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":11,"@type":70,"position":76},"https://docshare.wps.com/template/presentations/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/management-of-the-heart-failure-patient-in-the-primary-care-setting/563393/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/management-of-the-heart-failure-patient-in-the-primary-care-setting/563393.png","ImageObject",442,249,{"name":88,"@type":89},"Indoniesian Boy","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-22","2026-10-12",true,{"@type":98,"interactionType":99,"userInteractionCount":79},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"How is heart failure defined in the article?","Question",{"text":108,"@type":109},"Heart failure is described as a clinical syndrome with signs and symptoms caused by structural or functional cardiac abnormalities, leading to compromised cardiac output and/or elevated intracardiac filling pressures at rest or stress.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What are common signs and symptoms when a patient presents with heart failure?",{"text":113,"@type":109},"The patient typically has fluid overload causing dyspnoea, orthopnoea, jugular venous distension, pulmonary crepitations, and ankle oedema. Severe low cardiac output may also cause hypotension, cold extremities, decreased urine output, and altered mentation.",{"name":115,"@type":106,"acceptedAnswer":116},"What self-care measures are recommended for heart failure patients?",{"text":117,"@type":109},"Patients should discuss and set treatment goals, restrict salt and fluid intake to an individualized degree, stop smoking and avoid alcohol, and be screened for depression. They should practice self-care with symptom surveillance and daily weight monitoring, and be encouraged to undertake regular aerobic exercise.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},563393,1792359890,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":8,"category_name":11,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":47,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":73},962090760608,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Practice Integration & Lifelong Learning  \nSingapore Med J 2020; 61(5): 225-229 [https://doi.org/10.11622/smedj.2020073](https://doi.org/10.11622/smedj.2020073)  \nCMEArticle  \nManagement of the heart failure patient in the primary care setting  \nWeiliang Huang1, MBBS, MRCP, Shao Guang Sheldon Lee1, MBBS, MRCP, Choon How How2,3, MMed, FCFP  \nMdm Teo Ah Mui, an 88-year-old woman, visited your clinic for her regular follow-up, as she had done for the past 20 years. She had just been discharged from the hospital after being admitted for an episode of heart failure last month. She asked about her new medications to protect her heart and regulate her fluid status, wanting to know if they were indeed good for her.  \nWHAT IS HEART FAILURE?  \nHeart failure (HF) is a clinical syndrome comprising signs and symptoms that result from a structural or functional cardiac abnormality, causing a compromise in cardiac output and/or elevated intracardiac filling pressures at rest or stress.(1) It is the result of any insult, such as coronary, valvular or arrhythmic, causing a disturbance to cardiac function.  \nHOW RELEVANT IS THIS TO MY  \nPRACTICE?  \nHF is extremely prevalent in Singapore. About 20% of deaths in Singapore in 2017 were due to ischaemic heart disease and other cardiac diseases.(2) 4.5% of Singaporeans live with HF, compared to 1%–2% in the United States and Europe.  \nMany Singaporeans are also at risk of HF, with the most prevalent risk factors being insufficient physical activity (34% of the population), smoking (16%), obesity (35%), diabetes mellitus (10%) and hypertension (14%) . (3) These risk factors need to be adequately controlled to minimise the chance of developing HF or, in the case of a HF patient, controlled to retard progression of HF. Management of HF requires the patient’s involvement and a multidisciplinary team approach (Box 1) .  \nCommon signs and symptoms at presentation  \nThe patient typically develops and presents with fluid overload, which causes dyspnoea, orthopnoea, jugular venous distension, pulmonary crepitations and ankle oedema.(1,6) When there is severely depressed cardiac output, there can be hypotension, cold extremities, decreased urine output and altered mentation when the cardiac output is unable to support adequate tissue perfusion.(1) These patients should be promptly referred to the accident and emergency department.  \nA medical history of cardiovascular disease or cardiovascular risk factors makes the diagnosis of HF more likely. All stable patients suspected to have newly diagnosed HF should have  \nelectrocardiography (ECG) performed and be referred to a cardiologist for early evaluation.  \nWHAT CAN I DO IN MY PRACTICE?  \nAfter diagnosis, the HF patient should ideally be managed in the community, with follow-up to ensure that the patient has few or no symptoms. Repeated hospitalisations for HF is a strong predictor of mortality.(7)  \nPatient self-care  \nTreatment goals should first be discussed and established with the patient, preferably with the support of caregivers and family members.  \nHF patients should restrict their salt and fluid intake, albeit to varying degrees based on the individual patient’s profile and severity of HF. They should be counselled on smoking cessation and avoidance of alcohol (especially for alcoholrelated cardiac dysfunction), and screened for depression and managed accordingly.(8) Patients should also be taught self-care, symptom surveillance and weight monitoring, and advised to purchase a suitable water jug (e.g. 1-L jug) specifically for regulating water intake and a reliable weighing machine for daily weight measurements and recording. They should try as much as possible to comply with the fluid restrictions, and monitor themselves closely for symptoms such as ankle swelling if they exceed their restrictions on a hot day. Regular aerobic exercise should be encouraged to improve functional capacity and symptoms.(9)  \nChanges in functional status and/or a rapid ","cbCaikN9sS5SBpDE","https://ap.wps.com/l/cbCaikN9sS5SBpDE","pdf",251320,"English","# WHAT IS HEART FAILURE?\n## HOW RELEVANT IS THIS TO MY PRACTICE?\n# WHAT CAN I DO IN MY PRACTICE?\n## Patient self-care\n## Changes in functional status and rapid weight gain\n## Support for return to work\n# Box 1. Management strategy for a patient with heart failure","[{\"question\":\"How is heart failure defined in the article?\",\"answer\":\"Heart failure is described as a clinical syndrome with signs and symptoms caused by structural or functional cardiac abnormalities, leading to compromised cardiac output and/or elevated intracardiac filling pressures at rest or stress.\"},{\"question\":\"What are common signs and symptoms when a patient presents with heart failure?\",\"answer\":\"The patient typically has fluid overload causing dyspnoea, orthopnoea, jugular venous distension, pulmonary crepitations, and ankle oedema. Severe low cardiac output may also cause hypotension, cold extremities, decreased urine output, and altered mentation.\"},{\"question\":\"What self-care measures are recommended for heart failure patients?\",\"answer\":\"Patients should discuss and set treatment goals, restrict salt and fluid intake to an individualized degree, stop smoking and avoid alcohol, and be screened for depression. They should practice self-care with symptom surveillance and daily weight monitoring, and be encouraged to undertake regular aerobic exercise.\"}]","Management of the heart failure patient in the primary care setting | PDF",1791831121]