Treatment of acute heart failure

被引:0
作者
Simonis, Gregor [1 ]
Spitzer, Stefan G. [1 ]
Stumpf, Juergen [1 ]
Doerr, Rolf [1 ]
机构
[1] Praxisklin Herz & Gefasse, Forststr 3, D-01099 Dresden, Germany
关键词
Acute heart failure; Diuretics; Catecholamines; Vasodilators; Treatment; GOAL-DIRECTED RESUSCITATION; MYOCARDIAL-INFARCTION; CARDIOGENIC-SHOCK; RANDOMIZED-TRIAL; THERAPY; ULTRAFILTRATION; LEVOSIMENDAN; DOBUTAMINE; STRATEGIES; MANAGEMENT;
D O I
10.1007/s00059-015-4336-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Acute heart failure is a symptom complex of heterogeneous etiology. Clinically, it comprises a broad spectrum ranging from hypertensive pulmonary edema in patients with preserved left ventricular systolic function up to cardiogenic shock in patients with severely depressed left ventricular function. The pathophysiology of acute heart failure is based on a mismatch between myocardial pump function and afterload. Besides causal measures, vasodilators and diuretics are the mainstay of therapy. Catecholamines are indicated only when other drugs are unsuccessful. Opioids are often used in clinical practice but should be used cautiously as they are associated with a negative prognosis. Further adjunctive treatment consists of thromboembolism prophylaxis, non-invasive ventilation and in some cases mechanical circulatory support and renal replacement therapy. This article discusses the differential use of these treatment modalities.
引用
收藏
页码:823 / 831
页数:9
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