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Chapter 26 - Acute heart failure

from Section III: - Organ dysfunction and management

Published online by Cambridge University Press:  06 July 2010

By
Harjot Singh  and
Tony Whitehouse
Edited by
Fang Gao Smith
Edited in association with
Joyce Yeung
Fang Gao Smith
Affiliation:
University of Warwick
Joyce Yeung
Affiliation:
West Midlands Deanery
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Summary

Acute heart failure (AHF) may arise from systolic or diastolic dysfunction, rhythm disorder or preload and afterload mismatch from various aetiologies. The strongest sign is presence of a S3 or gallop rhythm on auscultation. Other clinical signs depend on the aetiology of AHF and its correlation with the history helps guide further investigation and treatment. The investigation is performed by electrocardiogram, and imaging techniques such as chest X-ray, computed tomography (CT), and echocardiography. For optimal management of AHF, full blood count, clotting, urea and electrolytes, blood glucose, cardiac enzymes, inflammatory markers and arterial blood gas analysis are recommended. The other investigations for AHF include coronary angiography, endomyocardial biopsy, and CT angiogram. The invasive monitoring of AHF is performed by arterial line, central venous lines, pulmonary artery flotation catheter and echocardiography. The management of AHF includes ventilatory support, the use of inotropes and renal replacement therapy.

Keywords

gastrointestinal systemhepatic systemintensive care unitrespiratory systemrenal systemneurological systemmultiple organ dysfunction syndromemultiple organ failuresepsis
Type
Chapter
Information
Core Topics in Critical Care Medicine , pp. 202 - 211
Publisher: Cambridge University Press
Print publication year: 2010

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