Acute Heart Failure Treatment

Introduction

Acute heart failure (AHF) is a serious condition where the heart suddenly becomes unable to pump blood effectively. This situation leads to symptoms like severe shortness of breath, fluid retention, and fatigue. AHF requires urgent medical attention to stabilize the patient and prevent complications.

Causes of Acute Heart Failure

Common causes of AHF include: - Exacerbation of chronic heart failure - Myocardial infarction (heart attack) - Uncontrolled hypertension - Arrhythmias (irregular heart rhythms) - Severe infections (e.g., sepsis) - Pulmonary embolism

Symptoms

• Sudden shortness of breath
• Fatigue and weakness
• Swelling in legs and abdomen
• Rapid or irregular heartbeat
• Coughing up pink, frothy sputum
• Confusion and dizziness due to reduced blood flow to the brain

Diagnosis

To diagnose AHF, doctors use: - Clinical assessment: Evaluating symptoms and physical findings - Blood tests: Checking for heart failure markers (e.g., NT-proBNP) - ECG: Detecting arrhythmias or myocardial ischemia - Echocardiography: Assessing heart function and structure - Chest X-ray: Identifying fluid accumulation in the lungs

Treatment Strategies

1. Immediate Stabilization

• Oxygen therapy for respiratory support
• Diuretics (e.g., furosemide) to reduce fluid overload
• Vasodilators (e.g., nitroglycerin) to reduce cardiac workload
• Non-invasive ventilation (e.g., CPAP or BiPAP) if needed

2. Hemodynamic Support

• Inotropes (e.g., dobutamine) in cases of low blood pressure and reduced cardiac output
• Vasopressors (e.g., norepinephrine) in severe hypotension

3. Long-Term Management

• Identifying and treating the underlying cause (e.g., coronary artery disease, high blood pressure)
• Adjusting chronic heart failure medications (beta-blockers, ACE inhibitors)
• Lifestyle modifications (dietary changes, fluid and salt restriction, physical activity guidance)
• Cardiac rehabilitation and patient education

Conclusion

AHF is a life-threatening condition that requires prompt and effective treatment. The primary goals are to relieve symptoms, stabilize the patient, and address the underlying cause to prevent future episodes. If you or a loved one experience sudden heart failure symptoms, seek emergency medical care immediately.

Source recommendations

1. American Heart Association Guidelines for the Management of Heart Failure

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
2. https://professional.heart.org/en/guidelines-and-statements
3. https://www.heart.org/en/health-topics/heart-failure
4. https://professional.heart.org/en/science-news/-/media/832EA0F4E73948848612F228F7FA2D35.ashx
5. https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure

2. European Society of Cardiology Guidelines for Acute and Chronic Heart Failure

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
2. https://academic.oup.com/eurheartj/article/42/36/3599/6358045
3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines
4. https://pubmed.ncbi.nlm.nih.gov/34447992/
5. https://academic.oup.com/eurheartj/article/44/37/3627/7246292