Acute heart failure: differential diagnosis and treatment. (26th April 2023)

• Record Type: Journal Article
• Authors: Marini, Marco; Manfredi, Roberto; Battistoni, Ilaria; Francioni, Matteo; Vittoria Matassini, Maria; Pongetti, Giulia; Angelini, Luca; Shkoza, Matilda; Bontempo, Alessandro; Belfioretti, Leonardo; Piero Perna, Gian
• Is Part Of: European heart journal supplements. Volume 25(2023)Supplement C
• Page Start: C276
• Page End: C282
• Publication Date: 2023-04-26
• Subjects: Acute heart failure -- Phenotypes -- Congestion -- Perfusion -- Cardiogenic shock -- Pulmonary artery catheter; Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartjsupp/suad027
• Languages: English
• ISSNs: 1520-765X

Abstract

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.