Der Internist
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Heart failure is a disease with a high prevalence and incidence. New therapeutic approaches are needed to prevent the onset of heart failure and to reduce the high morbidity and mortality associated with this disease. An optimized therapy of arterial hypertension in patients with risk factors and the use of the SGLT2 inhibitor empagliflozin in type 2 diabetics are proven strategies to prevent heart failure. ⋯ In heart failure with reduced ejection fraction sacubitril/valsartan, the first approved angiotensin receptor-neprilysin inhibitor, is superior to an angiotensin converting enzyme (ACE) inhibitor. Whether digitalis affects the prognosis in heart failure remains unclear; however, serum concentration should be targeted at the lower therapeutic range. Iron supplementation in heart failure with reduced systolic function and iron deficiency improves symptoms and quality of life.
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Headaches can be so severe that patients and doctors often fear life-threatening underlying cerebral pathologies. The spectrum of causes of headache is very heterogeneous and ranges from harmless situations to severe diseases, so that it is very difficult to consider all differential diagnoses simultaneously; however, a few targeted questions and physical examinations are sufficient to be able to make a better classification of the leading symptom headache. The following article serves as a quick guide for identification of patients at risk. It describes basic findings, red flags and specials warning signs that must immediately lead to emergency admission for further diagnostics.