[The treatment of chronic left ventricular insufficiency].

Left ventricular failure is caused by a variety of myocardial diseases and its symptoms results from adjustments attempted by the left ventricle and the circulatory system to cope with the initial myocardial pathology. Treatment of heart failure has various objectives, depending on whether one tries to correct the initial myocardial disease, or its consequences on the myocardium, or its repercussions on blood circulation, or, more simply, to alleviate the symptoms experienced by the patient. The ideal treatment of heart failure would include a drug acting on its cause, another drug to restore a degree of contraction and relaxation adjusted to the amount of load, a third drug bringing back to normal a perturbed peripheral circulation and a fourth drug to relieve the symptoms due to sodium retention. Such a treatment does not exist, and the management of chronic left ventricular failure can only be composite. Should it be prescribed from the start? This, increasingly, is the current trend.