Acute decompensated heart failure

Acute decompensated heart failure
Synonyms	ADHF
Pronounce	N/A
Specialty	Cardiology
Symptoms	Shortness of breath, fatigue, edema
Complications	Pulmonary edema, cardiogenic shock
Onset	Sudden
Duration	Variable
Types	N/A
Causes	Myocardial infarction, arrhythmia, hypertension, valvular heart disease
Risks	Coronary artery disease, diabetes mellitus, chronic kidney disease
Diagnosis	Clinical examination, echocardiography, chest X-ray
Differential diagnosis	Pneumonia, chronic obstructive pulmonary disease, pulmonary embolism
Prevention	N/A
Treatment	Diuretics, vasodilators, inotropes
Medication	Furosemide, nitroglycerin, dobutamine
Prognosis	Variable, depends on underlying cause and treatment
Frequency	Common
Deaths	Significant, especially in severe cases

Acute decompensated heart failure

Pulmonary edema as seen on chest X-ray

Elevated jugular venous pressure

Pedal edema

Acute decompensated heart failure (ADHF) is a sudden worsening of the signs and symptoms of heart failure, which typically includes difficulty breathing (dyspnea), leg or feet swelling, and fatigue. It is a common and potentially serious cause of acute respiratory distress.

Pathophysiology

ADHF is characterized by the rapid accumulation of fluid in the lungs due to the heart's inability to pump efficiently, leading to pulmonary edema. This condition can result from a variety of factors, including myocardial infarction, arrhythmias, or non-compliance with heart failure medications.

Clinical Presentation

Patients with ADHF often present with acute shortness of breath, orthopnea, and paroxysmal nocturnal dyspnea. Physical examination may reveal elevated jugular venous pressure (JVP), pulmonary rales, and peripheral edema, such as pedal edema.

Diagnosis

The diagnosis of ADHF is primarily clinical, supported by imaging and laboratory tests. A chest X-ray may show pulmonary congestion or edema, while an echocardiogram can assess cardiac function. Elevated levels of B-type natriuretic peptide (BNP) or N-terminal pro-BNP can also support the diagnosis.

Management

The management of ADHF involves stabilizing the patient, relieving symptoms, and addressing the underlying cause. Initial treatment often includes oxygen therapy, diuretics to reduce fluid overload, and vasodilators to decrease cardiac workload. In severe cases, inotropic agents or mechanical support may be necessary.

Prognosis

The prognosis of ADHF varies depending on the underlying cause and the patient's response to treatment. Early intervention and adherence to treatment regimens can improve outcomes and reduce the risk of recurrent episodes.

Related pages

• Heart failure
• Pulmonary edema
• Myocardial infarction
• Cardiomyopathy

Gallery

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  Pulmonary edema as seen on chest X-ray

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  Elevated jugular venous pressure

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  Pedal edema

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  Pulmonary edema in acute decompensated heart failure

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  Elevated jugular venous pressure

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  Pedal edema in acute decompensated heart failure