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Review
. 2007 Mar 13;176(6):797-805.
doi: 10.1503/cmaj.051620.

Management of acute decompensated heart failure

Larry A Allen  1 , Christopher M O'Connor
Affiliations
Review

Management of acute decompensated heart failure

Larry A Allen et al. CMAJ. .

Abstract

Acute decompensated heart failure represents a heterogeneous group of disorders that typically present as dyspnea, edema and fatigue. Despite the high prevalence of this condition and its associated major morbidity and mortality, diagnosis can be difficult, and optimal treatment remains poorly defined. Identification of the acute triggers for the decompensation as well as noninvasive characterization of cardiac filling pressures and output is central to management. Diuretics, vasodilators, continuous positive airway pressure and inotropes can be used to alleviate symptoms. However, few agents currently available for the treatment of acute decompensated heart failure have been definitively shown in large prospective randomized clinical trials to provide meaningful improvements in intermediate-term clinical outcomes. Multiple novel therapies are being developed, but previous treatment failures indicate that progress in the management of acute decompensated heart failure is likely to be slow.

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Figures

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Fig. 1: Approximation of cardiac systolic function and cardiac filling pressures in various acute illnesses.
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Fig. 2: Various targets for therapies used in the management of acute decompensated heart failure.. Photo by: Lianne Friesen and Nicholas Woolridge
See this image and copyright information in PMC

Comment in

  • Acute decompensated heart failure.
    Smithline HA. Smithline HA. CMAJ. 2007 Jul 17;177(2):175; author reply 175-6. doi: 10.1503/cmaj.1070054. CMAJ. 2007. PMID: 17638957 Free PMC article. No abstract available.
  • Acute decompensated heart failure.
    Nemeth J. Nemeth J. CMAJ. 2007 Jul 17;177(2):175; author reply 175-6. doi: 10.1503/cmaj.1070053. CMAJ. 2007. PMID: 17638958 Free PMC article. No abstract available.

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