Therefore, at the first sign or symptom of impending cardiac failure, patients should be fully digitalized and or given additional diuretic, and the response observed closely a if cardiac failure continues, despite adequate digitalization and diuretic therapy, propranolol therapy should be withdrawn gradually, if possible ; b if tachyarrhythmia is being controlled, patients should be maintained on combined therapy and the patient closely followed until threat of cardiac failure is over.
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