Skip to main content Accessibility help
×
Hostname: page-component-7479d7b7d-m9pkr Total loading time: 0 Render date: 2024-07-13T04:26:58.612Z Has data issue: false hasContentIssue false

18 - Acute Decompensated Heart Failure

from Section 4 - Cardiovascular Emergencies

Published online by Cambridge University Press:  02 November 2023

Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
Get access

Summary

  • Heart failure (HF) is a clinical syndrome marked by elevated filling pressures to maintain acceptable cardiac output. Current guidelines use left ventricular ejection fraction (LVEF) to distinguish between reduced (HFrEF; LVEF < 40%), preserved (HFpEF; LVEF > 50%) and midrange ejection fractions (HFmrEF; LVEF between 40–49%).

  • Beta blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor neprilysin inhibitors (ARNI), sodium-glucose transporter-2 (SGLT2) inhibitors and cardiac resynchronization therapy, among other therapies, improve outcomes in HFrEF. HFpEF management focuses on comorbidity management with recent data showing benefit from SGLT-2 inhibitor, empagliflozin.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Berbenetz, N, Wang, Y, Brown, J, et al. Non-invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema. Cochrane Database Syst Rev 2019;4(4):CD005351. https://doi.org/10.1002/14651858.CD005351.pub4Google ScholarPubMed
Ponikowski, P, Voors, AA, Anker, SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC [published correction appears in Eur Heart J 2016 Dec 30]. Eur Heart J 2016;37(27):21292200. https://doi.org/10.1093/eurheartj/ehw128CrossRefGoogle Scholar
Wang, K, & Samai, K. Role of high-dose intravenous nitrates in hypertensive acute heart failure. Am J Emerg Med 2020;38(1):132137. https://doi.org/10.1016/j.ajem.2019.06.046CrossRefGoogle ScholarPubMed
Yancy, CW, Jessup, M, Bozkurt, B, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2017;136(6):e137-e161. https://doi.org/10.1161/CIR.0000000000000509CrossRefGoogle Scholar
Yancy, CW, Jessup, M, Bozkurt, B, et al. 2013 ACCF/AHA guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;62(16):e147e239. https://doi.org/10.1016/j.jacc.2013.05.019CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×