A Chait

A Gray

A Harrison

A Maisel

A Mebazaa

AB Storrow

Adam J. Singer

AJ Singer

AS Go

AS Maisel

B Hiestand

Brian C. Hiestand

C Mueller

CF Horton

Chad M. Cannon

CS Wang

CW Yancy

D Lloyd-Jones

DB Diercks

DS Ander

DS Lee

G Cotter

G Landoni

GC Fonarow

HC Hancock

HK Wang

J Burkhardt

J Jaronik

J Schrager

J Spinar

JF Neuenschwander

JJ McMurray

JL Januzzi

JM Carratalá Perales

JR Teerlink

K Damman

K Kajimoto

KJ Hogg

L Cabrini

L Cardinale

L Gargani

LW Stevenson

M Al Deeb

M Gheorghiade

M Metra

MS Nieminen

NL Weintraub

NM Hawkins

PA Heidenreich

PA McCullough

PS Pang

Q Dao

RS Engineer

S Arques

S Collins

S Schembri

SN Goonewardena

SP Collins

T Liesching

TE Auble

V Mitrovic

WF Peacock

WF Peacock IV

William F. Peacock

WT Abraham

YW Wong

AbstractThe diagnosis of patients presenting to the emergency department with acute heart failure (AHF) is challenging due to the similarity of AHF symptoms to other conditions such as chronic obstructive pulmonary disease and pneumonia. Additionally, because AHF is most common in an older population, the presentation of coexistent pathologies further increases the challenge of making an accurate diagnosis and selecting the most appropriate treatment. Delays in the diagnosis and treatment of AHF can result in worse outcomes and higher healthcare costs. Rapid initiation of treatment is thus necessary for optimal disease management. Early treatment decisions for patients with AHF can be guided by risk-stratification models based on initial clinical data, including blood pressure, levels of troponin, blood urea nitrogen, serum creatinine, B-type natriuretic peptide, and ultrasound. In this review, we discuss methods for differentiating high-risk and low-risk patients and provide guidance on how treatment decisions can be informed by risk-level assessment. Through the use of these approaches, emergency physicians can play an important role in improving patient management, preventing unnecessary hospitalizations, and lowering healthcare costs. This review differs from others published recently on the topic of treating AHF by providing a detailed examination of the clinical utility of diagnostic tools for the differentiation of dyspneic patients such as bedside ultrasound, hemodynamic changes, and interrogation of implantable cardiac devices. In addition, our clinical guidance on considerations for initial pharmacologic therapy in the undifferentiated patient is provided. It is crucial for emergency physicians to achieve an early diagnosis of AHF and initiate therapy in order to reduce morbidity, mortality, and healthcare costs.</jats:p

Crossref

Critical Care

Considerations for initial therapy in the treatment of acute heart failure

https://ccforum.biomedcentral.com/track/pdf/10.1186/s13054-015-1114-3?site=ccforum.biomedcentral.com

Considerations for initial therapy in the treatment of acute heart failure

Abstract

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