A comprehensive review of inpatient heart failure management for the hospitalist

Abstract

Acute decompensated heart failure (ADHF) is a leading cause of hospital admissions and is associated with significant increases in morbidity and mortality, as well as marked impacts on quality of life. This review aims to guide hospital medicine providers in the management of ADHF from hospital admission to safe discharge. Hospitalists commonly care for HF patients in the acute phase, and a clear understanding of HF classification and etiologies is vital for guiding the evaluation and treatment of HF decompensation. Medical management of HF is centered around guideline-directed medical therapy (GDMT), agents which have been shown in large-scale studies to improve morbidity and mortality, while diuretics are used in adjunct to alleviate symptoms and improve volume status. As patients approach discharge, a multidisciplinary approach centering on patient education, counseling, and coordination of transitional care services can help to improve outcomes and reduce readmission risk.

Keywords: CHF; Congestive heart failure; GDMT; HFmrEF; HFpEF; HFrEF; discharge planning; hospital medicine; hospitalist; transitions of care.