Heart Failure, Acutely Decompensated

Muhammad Durrani, DO, MS and Eric P. Blazar, MD Reviewed 06/2019

BASICS

DESCRIPTION

Acute decompensated heart failure (ADHF) is a rapid-onset cardiac pump function impairment, structurally or functionally, resulting in inefficient perfusion, yielding symptoms due to...

DIAGNOSIS

Requires a multifaceted clinical approach with no gold standard diagnostic test: No single historical, physical exam (PE), ECG, or radiographic finding can rule out HF.

HISTORY

Patients typic...

TREATMENT

Goal of treatment is to improve hemodynamics and organ perfusion, alleviate symptoms, limit cardiac and renal damage, restore oxygenation, and minimize hospital length of stay as well as ide...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Rapid follow-up and a multidisciplinary care to reduce hospitalization and mortality (1)[A]

DIET

Reduce sodium (2 g); maintain cardiac or diabeti...

REFERENCES

Ponikowski P, Voors AA, Anker SD, et al; for ESC Scientific Document Group. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the d...

CODES

ICD10

I50.9 Heart failure, unspecified
I50.21 Acute systolic (congestive) heart failure
I50.31 Acute diastolic (congestive) heart failure
I50.41 Acute combined systolic and diastolic (congestive) hr...

CLINICAL PEARLS

BNP in ADHF is best reserved for situations in which diagnosis of ADHF is unclear.
Look for underlying cause of each episode of ADHF.
IV diuretics are used initially in fluid-overload ac...

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