A narrative review on the management of Acute Heart Failure in Emergency Medicine Department

被引:5
作者
Saberinia, Amin [1 ,2 ]
Vafaei, Ali [1 ,2 ]
Kashani, Parvin [1 ,2 ]
机构
[1] Shahid Beheshti Univ Med Sci, Sch Med, Dept Emergency Med, Tehran, Iran
[2] Shahid Beheshti Univ Med Sci, Sch Med, Loghman Hakim Hosp, Dept Emergency Med, Tehran, Iran
关键词
Emergency medicine; heart failure; diagnosis; management; EUROPEAN-SOCIETY; TASK-FORCE; MYOCARDIAL-INFARCTION; EJECTION FRACTION; CARDIOLOGY; RISK; ASSOCIATION; GUIDELINES; ELEVATION; OUTCOMES;
D O I
10.4081/ejtm.2019.8612
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
The main urgent symptom presented to an emergency department is acute heart failure (AHF). In that considerable risksof morbidity and mortality, it is important to plan precision medicine to achieve the most suitable outcomes. The object of this review is to provide a summary of contemporary management procedures of emergency medicine in a department of acute heart failure. Heart failure could be presented with a broad range of symptoms, in particular a sudden worsening of those of Chronic Obstructive Pulmonary Disease. The treatment should focus on acute and chronic underlying disorders with instructions focusing on haemodynamics and blood pressure status. Treatment of patients suffering with worsening symptoms of AHF mainly focuses on intravenous diuretics. In emergency situations, patients suffering with AHF with low blood pressure must receive emergency consultation and a primary fluid bolus therapy (range 250-500 mL) followed by inotropic therapy with or without antihypotensive agents. For treatment of severe heart failure and cardiogenic shock in patients treated with noradrenalin, when blood pressure support is required, a direct-acting inotropic agent, dobutamine, could be applied effectively. When non-invasive positive pressure ventilation is needed, suppliers must track for any possibility of sudden worsening, i.e., for acute decompensated heart failure. When cardiac output is high the disorder could be treated with vasopressors.
引用
收藏
页码:171 / 178
页数:8
相关论文
共 48 条
[1]   Focus on renal congestion in heart failure [J].
Afsar, Baris ;
Ortiz, Alberto ;
Covic, Adrian ;
Solak, Yalcin ;
Goldsmith, David ;
Kanbay, Mehmet .
CLINICAL KIDNEY JOURNAL, 2016, 9 (01) :39-47
[2]  
Bakosis G., 2017, CONTIN CARDIOL ED, V3, P100, DOI [10.1002/cce2.58, DOI 10.1002/CCE2.58]
[3]   Impact of an Emergency Department Observation Unit Management Algorithm for Atrial Fibrillation [J].
Bellew, Shawna D. ;
Bremer, Merri L. ;
Kopecky, Stephen L. ;
Lohse, Christine M. ;
Munger, Thomas M. ;
Robelia, Paul M. ;
Smars, Peter A. .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2016, 5 (02)
[4]  
Benjamin EJ, 2019, CIRCULATION, V139, pE56, DOI [10.1161/CIR.0000000000000746, 10.1161/CIR.0000000000000659]
[5]   Outcomes and Care of Patients With Acute Heart Failure Syndromes and Cardiac Troponin Elevation [J].
Braga, Juarez R. ;
Tu, Jack V. ;
Austin, Peter C. ;
Chong, Alice ;
You, John J. ;
Farkouh, Michael E. ;
Ross, Heather J. ;
Lee, Douglas S. .
CIRCULATION-HEART FAILURE, 2013, 6 (02) :193-+
[6]   BNP and NT-proBNP as Diagnostic Biomarkers for Cardiac Dysfunction in Both Clinical and Forensic Medicine [J].
Cao, Zhipeng ;
Jia, Yuqing ;
Zhu, Baoli .
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 2019, 20 (08)
[7]   The Hospitalization Burden and Post-Hospitalization Mortality Risk in Heart Failure With Preserved Ejection Fraction Results From the I-PRESERVE Trial (Irbesartan in Heart Failure and Preserved Ejection Fraction) [J].
Carson, Peter E. ;
Anand, Inder S. ;
Win, Sithu ;
Rector, Thomas ;
Haass, Markus ;
Lopez-Sendon, Jose ;
Miller, Alan ;
Teerlink, John R. ;
White, Michel ;
McKelvie, Robert S. ;
Komajda, Michel ;
Zile, Michael R. ;
McMurray, John J. ;
Massie, Barry .
JACC-HEART FAILURE, 2015, 3 (06) :429-441
[8]  
Cerlinskaite K, 2018, KOREAN CIRC J, V48, P463
[9]   Editor's Choice- Call to action: Initiation of multidisciplinary care for acute heart failure begins in the Emergency Department [J].
Christ, Michael ;
Mueller, Christian .
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE, 2016, 5 (02) :141-149
[10]   ACUTE Heart Failure Risk Stratification A Step Closer to the Holy Grail? [J].
Collins, Sean P. ;
Pang, Peter S. .
CIRCULATION, 2019, 139 (09) :1157-1161