Q&A: A question has been raised about why the indication for giving GTN for heart failure has changed. It used to be that the systolic blood pressure had to be 90mmHg to administer GTN; the updated JRCALC guideline for heart failure states that systolic blood pressure has to be 110mmHg to administer GTN. The heart failure guideline was updated in 2018 according to the article ‘Recommendations on pre-hospital & early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine’, published in the European Journal of Heart Failure in 2015. The indication for GTN has changed to: Breathlessness due to pulmonary oedema in acute heart failure when systolic blood pressure is greater than 110mmHg.
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