Action of digitalis in latent cardiac failure

TREATMENT OF CARDIAC FAILURE CONSISTS OF THREE PRINCIPAL METHODS OR A COMBINATION OF THEM: (a) rest, or reduction of overload; (b) diuretic therapy and sodium restriction, and (c) administration of digitalis. In a series of patients treatment with the aid of the first two methods was compared with the effect of adding digitalis to this regimen.Clinically, most patients can be brought back to a state of compensation without the use of digitalis. Hemodynamically, digitalis exerts a further favorable action by improving cardiac performance. The discrepancy between clinical and hemodynamic cardiac state is emphasized, for patients may have no clinical evidence of cardiac failure and yet show hemodynamic abnormalities characteristic of serious impairment of cardiac performance. Thus digitalis has been shown to exert a favorable effect in cardiac failure even if such an effect cannot be clinically assessed.