Acute Heart Failure
Categories of Acute Heart Failure
- Acute Decompensated HF
- With signs and symptoms of AHF which are mild and do not complete criteria for cardiogenic shock, pulmonary edema, or hypertensive crisis
- Hypertensive AHF
- HF w/elevated BP and relatively preserved LV function with a CXR with acute pulmonary edema
- AHF with Pulmonary Edema
- Severe respiratory distress with crackles and orthopnea
- High-Output Heart Failure
- High CO, commonly with elevated HR 2/2 arrhythmia, thyrotoxicosis, anemia, Paget’s Disease, Iatrogenic
- Right-Sided Heart Failure
- Low CO with increased JVD, hepatomegaly, and hypotension
- Cardiogenic Shock
Severity
- Dry-Warm: Adjust oral therapy
- Dry-Cold: Fluid Challenge/Inotropes
- Wet-Warm:
- Hypertension: Vasodilators/Diuretics
- Congestion: Diuretics, Vasodilators, Ultrafiltration
- Wet-Cold:
- Systolic <90: Inotropes, Vasopressors, Diuretics, Circulatory support
- Systolic >90: Vasodilators, Diuretics, Inotropes