[The treatment of acute severe cardiac insufficiency]

The clinical syndrome of severe acute heart failure may be caused by several distinct mechanisms. Some of these require a specific approach in addition to general measures, and prompt diagnosis is thus of great importance in order to define the initial and long-term therapeutic targets. This review recalls the basic principles of differential diagnosis and pharmacological treatment. The logistics of diagnosis and treatment inside the hospital are also discussed. The respective uses of mechanical ventilation, intraaortic balloon counterpulsation and ventricular assist devices are outlined.