Acute heart failure: differential diagnosis and treatment

Abstract Acute heart failure is a heterogeneous clinical syndrome and is the first cause of unplanned hospitalization in people >65 years. Patients with heart failure may have different clinical presentations according to clinical history, pre-existing heart disease, and pattern of intravascular...

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Veröffentlicht in:European heart journal supplements 2023-05, Vol.25 (Supplement_C), p.C276-C282
Hauptverfasser: Marini, Marco, Manfredi, Roberto, Battistoni, Ilaria, Francioni, Matteo, Vittoria Matassini, Maria, Pongetti, Giulia, Angelini, Luca, Shkoza, Matilda, Bontempo, Alessandro, Belfioretti, Leonardo, Piero Perna, Gian
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Sprache:eng
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Zusammenfassung:Abstract Acute heart failure is a heterogeneous clinical syndrome and is the first cause of unplanned hospitalization in people >65 years. Patients with heart failure may have different clinical presentations according to clinical history, pre-existing heart disease, and pattern of intravascular congestion. A comprehensive assessment of clinical, echocardiographic, and laboratory data should aid in clinical decision-making and treatment. In some cases, a more accurate evaluation of patient haemodynamics via a pulmonary artery catheter may be necessary to undertake and guide escalation and de-escalation of therapy, especially when clinical, echo, and laboratory data are inconclusive or in the presence of right ventricular dysfunction. Similarly, a pulmonary artery catheter may be useful in patients with cardiogenic shock undergoing mechanical circulatory support. With the subsequent de-escalation of therapy and haemodynamic stabilization, the implementation of guideline-directed medical therapy should be pursued to reduce the risk of subsequent heart failure hospitalization and death, paying particular attention to the recognition and treatment of residual congestion.
ISSN:1520-765X
1554-2815
DOI:10.1093/eurheartjsupp/suad027