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Diagnosis and Management of Acute Heart Failure

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MGH Cardiology Board Review

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Abstract

Heart failure (HF) is a complex disorder that consists of a clinical syndrome with symptoms associated with pulmonary or systemic congestion with or without poor cardiac output. Acute heart failure is defined as acute onset of signs and symptoms of HF requiring urgent or emergent intervention. Symptoms may be of new onset or recurrent. Acute HF can be associated with reduced LV systolic dysfunction (HFrEF or Systolic HF) or can occur in patients with preserved LV ejection fraction (LVEF) (HFpEF or diastolic HF); up to 50 % of patients hospitalized with acute HF have preserved LV systolic function. It is important to recognize that acute HF can present without signs and symptoms of congestion and patients may only have manifestations of low cardiac output and cardiogenic shock.

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Abbreviations

ACC:

American college of cardiology

ACE:

Angiotensin converting enzyme

ACS:

Acute coronary syndromes

ADHF:

Acute decompensated heart failure

AHA:

American heart association

AR:

Aortic regurgitation

ARB:

Angiotensin II receptor blocker

BNP:

B-type natriuretic peptides

BUN:

Blood urea nitrogen

Ca:

Calcium

cAMP:

Cyclic adenosine monophosphate

CBC:

Complete blood count

Cr:

Creatinine

CRT:

Cardiac resynchronization therapy

CVA:

Cerebrovascular accident

CXR:

Chest X-ray

HF:

Heart failure

HFpEF:

Heart failure with preserved ejection fraction

HFrEF:

Heart failure with reduced ejection fraction

HFSA:

Heart Failure Society of America

ICD:

Implantable cardioverter defibrillator

JVP:

Jugular venous pressure

K:

Potassium

LFT:

Liver function tests

LV:

Left ventricle

LVEF:

Left ventricle ejection fraction

MCS:

Mechanical circulatory support

Mg:

Magnesium

Na:

Sodium

NSAIDS:

Nonsteroidal anti-inflammatory drugs

NT-proBNP:

N-terminal proBNP

NYHA:

New York Heart Association

PAD:

Peripheral arterial disease

PCWP:

Pulmonary capillary wedge pressure

PVC:

Premature ventricular contractions

PVR:

Pulmonary vascular resistance

RV:

Right ventricular

SVR:

Systemic vascular resistance

TIA:

Transient ischemic attack

VAD:

Ventricular Assist Devices

VT:

Ventricular tachycardia

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Author information

Authors and Affiliations

  1. Harvard Medical School Advanced Heart Failure and Cardiac Transplantation, Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Kimberly A. Parks DO (Instructor in Medicine)

  2. Harvard Medical School, Boston, USA

    James L. Januzzi Jr. MD (Associated Professor)

  3. Cardiac Intensive Care Unit, Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    James L. Januzzi Jr. MD (Roman W. Desanctis Endowed Distinguished Clinical Scholar, Director)

Authors
  1. Kimberly A. Parks DO
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  2. James L. Januzzi Jr. MD
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Editor information

Editors and Affiliations

  1. Cardiology Division Yawkey Building 5B, Room 5850, Massachusetts General Hospital, Boston, Massachusetts, USA

    Hanna K. Gaggin

  2. Cardiology Division Yawkey Building, Suite 5984, Massachusetts General Hospital, Boston, Massachusetts, USA

    James L. Januzzi, Jr.

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Parks, K.A., Januzzi, J.L., Januzzi, J.L. (2014). Diagnosis and Management of Acute Heart Failure. In: Gaggin, H., Januzzi, Jr., J. (eds) MGH Cardiology Board Review. Springer, London. https://doi.org/10.1007/978-1-4471-4483-0_14

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  • DOI: https://doi.org/10.1007/978-1-4471-4483-0_14

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