Acute heart failure (AHF) represents the first reason for
hospitalization in the elderly and despite therapeutic advances, remains
a syndrome with significant morbidity and dismal prognosis.
Hospitalization for AHF, on the other hand, is the single most important
contributor to the huge financial burden related to HF. As a result,
there is a significant unmet need for more effective in-hospital
management of patients with AHF in order to improve outcomes, reduce
readmission rate and alleviate the socioeconomic burden of the syndrome.
The in hospital management of AHF patients may schematically be divided
into three phases, an early phase of intensive management of congestion
and/or hypoperfusion, an intermediate phase of transition to oral
life-saving medications and a late phase of discharge and transition to
outpatient management. In the present paper, we attempt to provide a
concise and practical roadmap for each of the above phases, focusing
mainly on defining clinical and laboratory criteria for the evaluation
of patients and on describing therapeutic algorithms that summarize the
available evidence and guidelines. In addition, we highlight some key
open issues that need to be addressed by future research. (C) 2015
Elsevier Ireland Ltd. All rights reserved