Acute decompensated heart failure update

John R Teerlink, Khalid Alburikan, Marco Metra

  • 1Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7569, Chapel Hill, NC 27599, USA. jerodgers@unc.edu.

Current Cardiology Reviews
|November 21, 2013
PubMed

Insights

Acute decompensated heart failure (ADHF) is rising, increasing hospitalizations and costs. This review updates clinicians on the optimal evaluation and management of ADHF to improve patient outcomes.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Acute decompensated heart failure (ADHF) prevalence and associated mortality/morbidity are increasing.
  • Projected rise in heart failure (HF) cases to over 8 million Americans by 2030, with costs escalating to $70 billion.
  • Demographic shifts and population growth are key drivers of the increasing HF burden.

Purpose of the Study:

  • To provide an updated review for clinicians on the evaluation and optimal management of ADHF.
  • To address the growing need for evidence-based strategies in ADHF care.
  • To synthesize recent findings relevant to ADHF treatment.

Main Methods:

  • Review of recent clinical trials and guidelines focused on ADHF management.
  • Synthesis of current evidence regarding diagnostic and therapeutic approaches for ADHF.
  • Focus on practical updates for clinical practice.

Main Results:

  • Recent studies increasingly focus on ADHF management, moving beyond chronic HF research.
  • Emerging data provides new insights into optimal diagnostic tools and treatment strategies for ADHF.
  • The review consolidates key findings to guide clinical decision-making.

Conclusions:

  • Optimal management of ADHF requires updated clinical knowledge.
  • Clinicians need to be informed about the latest evidence for effective ADHF evaluation and treatment.
  • Addressing the rising burden of ADHF is crucial for improving patient outcomes and reducing healthcare costs.

Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
641
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
1.4K
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
635
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
2.1K
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
798
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
807