A narrative review on the management of Acute Heart Failure in Emergency Medicine Department


Submitted: 8 October 2019
Accepted: 8 November 2019
Published: 1 April 2020
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Authors

  • Amin Saberinia Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran; Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran, Islamic Republic of.
  • Ali Vafaei Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran; Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran, Islamic Republic of.
  • Parvin Kashani Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran; Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran, Islamic Republic of.

The main urgent symptom presented to anemergency departmentis acute heart failure (AHF). In that considerable risksof morbidity and mortality, it isimportant to plan precision medicine to achieve the most suitable outcomes. The object of this review is to provide a summary of contemporary management proceduresof emergency medicine in a department of acute heart failure. Heart failure could be presented with a broad range of symptoms, in particular a sudden worsening of those of Chronic Obstructive Pulmonary Disease. The treatment should focus on acute and chronic underlying disorders with instructions focusing on haemodynamics and blood pressure status. Treatment of patients suffering with worsening symptoms of AHF mainly focuses on intravenous diuretics. In emergency situations, patients suffering with AHF with low blood pressure must receive emergency consultation and a primary fluid bolus therapy (range 250–500 mL) followed by inotropic therapy with or without antihypotensive agents. For treatment of severe heart failure and cardiogenic shock in patients treated with noradrenalin, when blood pressure support is required, a direct-acting inotropic agent, dobutamine, could be applied effectively. When non-invasive positive pressure ventilation is needed, suppliers must track for any possibility of sudden worsening, i.e., for acute de compensated heart failure. When cardiac output is high the disorder could be treated with vasopressor.


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