JOURNAL ARTICLE
REVIEW

Review: Evidence-Based Management of Acute Heart Failure

Arjun K Gupta, Daniela Tomasoni, Kiran Sidhu, Marco Metra, Justin A Ezekowitz
Canadian Journal of Cardiology 2021 January 10
33440229
Acute heart failure (AHF) is a complex, heterogeneous clinical syndrome with high morbidity and mortality, incurring significant healthcare costs. Patients transition from home to the emergency department, the hospital and home again, and require decisions surrounding diagnosis, treatment and prognosis at each step of the way. The purpose of this review is to examine the epidemiology, etiologies and classifications of AHF, and specifically focus on practical information relevant to the clinician. We examine the mechanisms of decompensation relevant to clinical presentations, including precipitating factors, neuroendocrine interactions and inflammation, along with how consideration of these factors these may help select therapies for an individual patient. The prevalence and significance of end-organ manifestations like renal, gastrointestinal, respiratory and neurologic manifestations are discussed. We also highlight how the development of renal dysfunction relates to the choice of a variety of diuretics that may be useful in specific circumstances and review guideline-directed medical therapy. We discuss the practical use (and pitfalls) of a variety of evidence-based clinical scoring criteria available to risk stratify patients with AHF. Finally, evidence-based management of AHF is discussed, including both pharmacologic and nonpharmacologic therapies, including the lack of evidence for using old and new vasodilators and the recent evidence regarding initiation of newer therapies in hospital. Overall, we suggest that clinicians consider implementing the newer data in AHF and subject existing practice patterns and treatments to the same rigor as new therapies.

Full Text Links

We have located open access full text paper links.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read
33440229
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"