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Evidence-Based Management of Acute Heart Failure
Arjun K Gupta1, Daniela Tomasoni2, Kiran Sidhu3
1Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
The Canadian Journal of Cardiology
|January 13, 2021
Summary
Acute heart failure (AHF) management requires clinicians to integrate new data. This review covers AHF epidemiology, causes, and practical clinical strategies for diagnosis, treatment, and prognosis.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Acute heart failure (AHF) is a significant clinical syndrome characterized by high morbidity, mortality, and healthcare costs.
- Patient care involves complex decision-making across multiple healthcare settings.
Purpose of the Study:
- To review the epidemiology, etiology, and classifications of AHF.
- To provide practical clinical information on AHF management, focusing on decompensation mechanisms and end-organ manifestations.
Main Methods:
- Literature review focusing on AHF epidemiology, pathophysiology, clinical presentations, and management strategies.
- Examination of precipitating factors, neuroendocrine interactions, inflammation, and end-organ dysfunction.
- Review of guideline-directed medical therapy, clinical scoring criteria, and evidence-based pharmacologic and non-pharmacologic treatments.
Main Results:
- AHF decompensation involves precipitating factors, neuroendocrine responses, and inflammation, influencing therapeutic choices.
- Renal dysfunction impacts diuretic selection; guideline-directed therapy and risk stratification tools are crucial.
- Evidence for vasodilators is limited, while newer therapies show promise for inpatient initiation.
Conclusions:
- Clinicians should consider incorporating recent AHF data into practice.
- Existing treatment patterns and therapies warrant rigorous evaluation alongside new interventions.
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