[Perioperative management of anesthesia in heart failure]

Heart failure is a significant risk factor for perioperative complications and postoperative mortality. A detailed medical history and physical examination during the preoperative consultation should guide decisions regarding further measures, such as the assessment of cardiac biomarkers, iron supplementation or echocardiography. Particularly in acutely decompensated patients, an interdisciplinary discussion should take place regarding the possibility of compensating the condition before an elective procedure. Preoperative cardiac medication should be adjusted or paused as needed. Adequate monitoring should enable a differentiated anesthesia induction, anesthesia management and postoperative monitoring to improve patient outcome. Intraoperative anesthesia management should include maintaining normotensive blood pressure, volume management, and a differentiated catecholamine treatment.