Acute Heart Failure

  • Veli-Pekka Harjola
  • Héctor Bueno
  • John T. Parissis
Chapter

Abstract

Acute heart failure (AHF) is one the most common causes of hospitalization in the elderly patients. AHF occurs as the rapid development or progression of symptoms and/or signs of heart failure requiring urgent medical evaluation and treatment. AHF may present as a first occurrence (de novo) or, more frequently, as a consequence of acute decompensation of chronic HF, and may be caused by primary cardiac dysfunction or more frequently precipitated by extrinsic factors in patients with chronic heart failure. The diagnostics of AHF include careful clinical assessment, ECG, chest X-ray and natriuretic peptides, especially for exclusion of heart failure as the cause of dyspnea. Echocardiography should be performed in 48 h, if indicated. The management of AHF depends on the clinical presentation. Initial stabilization includes ventilatory support and haemodynamic stabilization. The most severe form of AHF, cardiogenic shock, bears high in-hospital mortality. Decongestion is managed with diuretics and vasodilators. Inotropes and inodilators are reserved for the minority of patients with hypoperfusion. Mechanical circulatory support may be indicated in the most severe cases.

Keywords

Acute heart failure Definition Classification Risk strafication Pulmonary oedema Cardiogenic shock Diagnostics Management Diuretics Vasodilators Nitrates Inotropes Inodilators Mechanical circulatory support Follow-up Disease management program 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Veli-Pekka Harjola
    • 1
  • Héctor Bueno
    • 2
    • 3
    • 4
  • John T. Parissis
    • 5
  1. 1.Division of Emergency Medicine, Department of Emergency Care and ServicesHelsinki University HospitalHelsinkiFinland
  2. 2.Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
  3. 3.Department of CardiologyHospital Universitario 12 de OctubreMadridSpain
  4. 4.Universidad Complutense de MadridMadridSpain
  5. 5.Attikon University HospitalAthensGreece

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