Acute exacerbation of congestive heart failure

Clinical syndrome of reduced cardiac output, tissue hypoperfusion, increased pulmonary pressure, and tissue congestion.

Presents with dyspnea, decreased exercise tolerance, swelling of the legs, fatigue, and generalized weakness.

Clinical diagnosis is supported by ancillary tests such as ECG, chest x-ray, B-type natriuretic peptide (BNP), and echocardiogram.

Diuretics and oxygen are initial treatments for symptom relief. Cardiogenic shock may require pressor support or mechanical ventilation.

If acute myocardial infarction (MI) is present, early revascularization is essential.

Heart failure is defined clinically as a syndrome in which patients have symptoms and signs resulting from an abnormality of cardiac structure or function. [1] Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur J Heart Fail. 2016 Dec;69(12):1167. http://eurheartj.oxfordjournals.org/content/early/2016/05/19/eurheartj.ehw128 http://www.ncbi.nlm.nih.gov/pubmed/27207191?tool=bestpractice.com [2] McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Eur Heart J. 2012 Jul;33(14):1787-847. http://eurheartj.oxfordjournals.org/content/33/14/1787.long http://www.ncbi.nlm.nih.gov/pubmed/22611136?tool=bestpractice.com Acute congestive heart failure (CHF) is the rapid onset of symptoms and signs of heart failure and may occur with or without previous cardiac disease. [1] Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur J Heart Fail. 2016 Dec;69(12):1167. http://eurheartj.oxfordjournals.org/content/early/2016/05/19/eurheartj.ehw128 http://www.ncbi.nlm.nih.gov/pubmed/27207191?tool=bestpractice.com [2] McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Eur Heart J. 2012 Jul;33(14):1787-847. http://eurheartj.oxfordjournals.org/content/33/14/1787.long http://www.ncbi.nlm.nih.gov/pubmed/22611136?tool=bestpractice.com