Treatment of acute heart failure

Acute heart failure is common in perioperative and critically-ill patients. Despite ongoing efforts to improve the management of acute heart failure, the short- and long-term prognosis remains poor. Acute cardiac failure is characterized by extensive aetiology and complex pathophysiology. While the diagnosis of acute heart failure is based primarily on clinical criteria, technical methods in particular electrocardiography and echocardiography - are required to ensure early diagnosis of underlying causes and the initiation of causal therapeutic strategies. Evidence-based therapeutic strategies are limited, and available only for a few types of acute heart failure. Inotropes and vasoconstrictors should be used sparingly and in a differentiated manner. Constant surveillance of the chosen therapeutic measures by means of advanced haemodynamic monitoring (echocardiography, measurement of cardiac output) is urgently recommended.