Review article

https://doi.org/10.21860/medflum2024_321526

Recommendation for the Diagnosis and Treatment of Acute Heart Failure

Ivan Brdar orcid.org/0000-0002-2467-4013 ; KBC Split, Objedinjeni hitni bolnički prijam, Split, Hrvatska *
Ivana Ferri Certić ; KBC Split, Objedinjeni hitni bolnički prijam, Split, Hrvatska
Vida Olujić ; KBC Split, Objedinjeni hitni bolnički prijam, Split, Hrvatska
Helena Milas ; KBC Split, Objedinjeni hitni bolnički prijam, Split, Hrvatska
Petra Jerković ; KBC Split, Objedinjeni hitni bolnički prijam, Split, Hrvatska
Mijo Meter ; KBC Split, Klinika za bolesti srca i krvnih žila, Split, Hrvatska
Josip Anđelo Borovac ; KBC Split, Klinika za bolesti srca i krvnih žila, Split, Hrvatska
Duška Glavaš ; KBC Split, Klinika za bolesti srca i krvnih žila, Split, Hrvatska

* Corresponding author.

Abstract

Heart failure is a clinical syndrome encompassing symptoms and signs resulting from an increase in intracardiac pressures or depressed cardiac output caused by structural and/or functional abnormalities of the heart. Acute heart failure (AHF) is a life-threatening condition that requires urgent care by the emergency medical service or unplanned hospitalization. Four main clinical presentations often overlap; these are acute decompensated heart failure, acute pulmonary edema, cardiogenic shock, and isolated right ventricular failure. The diagnosis of AHF is primarily based on clinical signs and symptoms and is supported by appropriate diagnostic examinations. Emergency medical service management consists of simultaneous clinical evaluation, necessary diagnostic procedures, and the application of specific therapy. Depending on the patient’s condition, treatment includes oxygen therapy and a wide range of non-invasive ventilation modalities, while essential pharmacological treatment usually includes intravenous diuretics and vasodilators, depending on the blood pressure values and the degree of congestion. Early intravenous administration of loop diuretics is the basis of AHF treatment. Inotropes are indicated for hemodynamic stabilization of patients with low cardiac output and hypotension. Advanced therapy of AHF in cases of AHF refractory to conservative treatment involves the application of mechanical circulatory support modalities.

Keywords

diuretics; heart failure; noninvasive ventilation; shock, cardiogenic; vasodilator agents

Hrčak ID:

321526

URI

https://hrcak.srce.hr/321526

Publication date:

1.12.2024.

Article data in other languages: croatian

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