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Acute Heart Failure

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Current Approach to Heart Failure

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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.

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Authors and Affiliations

  1. Division of Emergency Medicine, Department of Emergency Care and Services, Helsinki University Hospital, POB 340, FI-00029, HUS, Helsinki, Finland

    Veli-Pekka Harjola MD, PhD

  2. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain

    Héctor Bueno MD, PhD

  3. Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, Spain

    Héctor Bueno MD, PhD

  4. Universidad Complutense de Madrid, Madrid, Spain

    Héctor Bueno MD, PhD

  5. Attikon University Hospital, Athens, Greece

    John T. Parissis MD, PhD

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  1. Veli-Pekka Harjola MD, PhD
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  2. Héctor Bueno MD, PhD
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  3. John T. Parissis MD, PhD
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Correspondence to Veli-Pekka Harjola MD, PhD .

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Editors and Affiliations

  1. Emergency Clinical Hospital of Bucharest, UMF Carol Davila – Bucharest Emergency Clinical Hospital of Bucharest, Bucharest, Romania

    Maria Dorobanţu

  2. Department of Cardiology, University Heart Center Department of Cardiology, Zürich, Switzerland

    Frank Ruschitzka

  3. Section of Cardiovascular Diseases, University of Brescia Section of Cardiovascular Diseases, Brescia, Italy

    Marco Metra

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Harjola, VP., Bueno, H., Parissis, J.T. (2016). Acute Heart Failure. In: Dorobanţu, M., Ruschitzka, F., Metra, M. (eds) Current Approach to Heart Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-45237-1_23

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