Publicação
Acute heart failure – a revision
| Resumo: | Heart failure (HF) is a disease of the elderly and an important public health problem, due to a greater life span and multiple risk factor prevalence in developed societies, particularly arterial hypertension and coronary disease.The clinical syndrome of Acute Heart Failure (AHF) may present as acute new onset HF or as decompensated Chronic Heart Failure.Diagnosis is made mainly in a clinical basis, supported by complementary diagnostic tests, namely plasma brain natriuretic peptide (BNP), chest X-ray, electrocardiogram (ECG) and Echocardiography.The aim of therapy of AHF is to correct hypoxia, increase cardiac output, renal perfusion, sodium excretion and urine output. It´s essential to maintain SaO2 > 94%, to promote vasodilatation by nitrates use, to force the diuresis with furosemide (continuous infusion after intravenous bolus) and correct the metabolic disturbances and organ-specific dysfunctions (particularly the renal one).Further specific therapies (e.g., the use of inotropic agents), should be administered based on the clinical and haemodynamic characteristics of the patient who does not respond to initial treatment. The scientific societies have been producing Guidelines and Consensus with regularity, being the one of the European Society of Cardiology (2005), a very important bibliographical source in the present revision. |
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| Autores principais: | Teixeira, Mário |
| Outros Autores: | Tavares, Luís Pedro |
| Assunto: | insuficiência cardíaca BNP fibrilhação auricular heart failure BNP atrial fibrillation |
| Ano: | 2007 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Instituição associada: | Sociedade Portuguesa de Medicina Interna |
| Idioma: | português |
| Origem: | Revista Portuguesa de Medicina Interna |
| Resumo: | Heart failure (HF) is a disease of the elderly and an important public health problem, due to a greater life span and multiple risk factor prevalence in developed societies, particularly arterial hypertension and coronary disease.The clinical syndrome of Acute Heart Failure (AHF) may present as acute new onset HF or as decompensated Chronic Heart Failure.Diagnosis is made mainly in a clinical basis, supported by complementary diagnostic tests, namely plasma brain natriuretic peptide (BNP), chest X-ray, electrocardiogram (ECG) and Echocardiography.The aim of therapy of AHF is to correct hypoxia, increase cardiac output, renal perfusion, sodium excretion and urine output. It´s essential to maintain SaO2 > 94%, to promote vasodilatation by nitrates use, to force the diuresis with furosemide (continuous infusion after intravenous bolus) and correct the metabolic disturbances and organ-specific dysfunctions (particularly the renal one).Further specific therapies (e.g., the use of inotropic agents), should be administered based on the clinical and haemodynamic characteristics of the patient who does not respond to initial treatment. The scientific societies have been producing Guidelines and Consensus with regularity, being the one of the European Society of Cardiology (2005), a very important bibliographical source in the present revision. |
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