[Acute heart failure]
- PMID: 30145979
- DOI: 10.1024/0040-5930/a000980
[Acute heart failure]
Abstract
Acute heart failure Abstract. Acute heart failure (AHF) is a life-threatening condition requiring immediate treatment. The initial therapy should take into account the clinical presentation, the pathophysiology at play, the precipitating factors, and the underlying cardiac pathology. Particular attention should be given to polymorbidity and the avoidance of potential iatrogenic harms. Patient preferences and ethical issues should be integrated into the treatment plan at an early stage. The average survival of AHF patients is two years and the most vulnerable period is the three-month time window directly after discharge. Therefore, reducing both persistent subclinical congestion and underutilization of disease-modifying heart failure therapies as well as ensuring optimal transitions of care after hospital discharge are essentials in improving outcomes of AHF patients.
Zusammenfassung. Akute Herzinsuffizienz (AHF) ist eine lebensbedrohliche Erkrankung, die eine sofortige Behandlung erfordert. Die initiale Therapie sollte die klinische Präsentation, die pathophysiologischen Mechanismen, die auslösenden Faktoren und die zugrundeliegende Herzpathologie berücksichtigen. Besondere Aufmerksamkeit sollte der Polymorbidität und der Vermeidung potentieller iatrogener Schäden gewidmet werden. Patientenpräferenzen, Langzeitoptionen und ethische Fragen sollten frühzeitig in den Behandlungsplan integriert werden. Die Prognose von AHF-Patienten ist ernst, und die kritischste Zeitspanne stellen die ersten drei Monate direkt nach der Spitalentlassung dar. Daher ist es für die Verbesserung der Prognose von AHF-Patienten unerlässlich, die persistierende subklinische systemische Stauung zu vermeiden, den Einsatz von krankheitsmodifizierenden Herzinsuffizienz-Therapien zu optimieren und optimale Versorgungsübergänge nach der Spitalentlassung sicherzustellen.
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