Windhi Dwijanarko RSU DADI KELUARGA, PURWOKERTO ACUTE HEART FAILURE Windhi Dwijanarko RSU DADI KELUARGA, PURWOKERTO

Introduction Heart failure (HF) is one of the most important causes of morbidity and mortality in the world. The prevalence of symptomatic HF is estimated to range from 0.4 to 2.0% in general European population. Definition of Acute Heart Failure: Rapid onset or worsening of symptoms and/or signs of Heart Failure. It is a life-threatening medical condition requiring urgent evaluation and treatment  typically leading to urgent hospital admission.

Classification Classification by 2016 ESC Guidelines: New onset/ first occurrence (de novo) HF Worsening/ acute decompensation of chronic heart failure Classification by the EuroHeart Failure Survey II (EHFS II), 2006: Decompensated HF Pulmonary Oedema Cardiogenic shock Hypertensive HF Right heart failure

Diagnosis Initial diagnosis of AHF should be based on a thorough history assessing symptoms, prior cardiovascular history and potential cardiac and non-cardiac precipitants. Typically, symptoms and signs of AHF reflect: Fuid overload (pulmonary congestion and/or peripheral oedema), dyspneu, orthopneu, jugular venous distension hepatomegaly, rales. Less often, reduced cardiac output with peripheral hypoperfusion, fatigue, weakness, decreased urine output.

Diagnosis

Diagnostic Tools Chest X-ray - Pulmonary venous congestion, pleural effusion, interstitial or alveolar oedema and cardiomegaly; or to identify non-cardiac Electrocardiography (ECG) - underlying cardiac disease and potential precipitants (rapid AF, acute myocardial ischaemia). Echocardiography - only in patients with haemodynamic instability (particularly in cardiogenic shock). BNP/ NT-proBNP - to help differentiating of AHF from non-cardiac causes of acute dyspnoea.

Triggering Factors

Forrester classification

Initial Management

Pharmacotherapy

Diuretics type and dose

Vasodilator & Inotrope/ Vasopressor

Goal of Treatment

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