Heart failure. Diagnostics and treatment according to the ESC guidelines 2021

The prevalence of heart failure is on the rise and associated with considerable morbidity and mortality. Optimal primary prophylaxis, early diagnosis and guideline-conform pharmaceutical and nonpharmaceutical treatment can alleviate the clinical symptoms, prevent recurrent hospitalization and prolong patient survival. With the development of the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan and sodium-glucose transporter 2 (SGLT2) inhibitors, decisive progress was achieved in recent years regarding pharmacological treatment, for the first time also in heart failure with preserved ejection fraction (HFpEF). Moreover, promising results were obtained with the new active agents vericiguat and omecamtiv mecarbil. This article summarizes the essential recommendations for the diagnostics and treatment of heart failure based on the current guidelines of the European Society of Cardiology (ESC).