How to tackle congestion in acute heart failure

Acute heart failure is a common complication of chronic heart failure and is associated with a high risk for subsequent mortality and morbidity. In 90% of case acute heart failure is the resultant of congestion, a manifestation of fluid build-up due to increased filling pressures. As residual conges...

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Bibliographic Details
Published in:The Korean journal of internal medicine 2018, 33(3), , pp.462-473
Main Authors: Martens, Pieter, Mullens, Wilfried
Format: Article
Language:English
Subjects:
Heart Failure - complications
Heart Failure - therapy
Humans
Review
내과학
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Summary:Acute heart failure is a common complication of chronic heart failure and is associated with a high risk for subsequent mortality and morbidity. In 90% of case acute heart failure is the resultant of congestion, a manifestation of fluid build-up due to increased filling pressures. As residual congestion at discharge following an acute heart failure episodes is one of the strongest predictors of poor outcome, the goal of therapy should be to resolve congestion completely. Important to comprehend is that increased cardiovascular filling pressures are not solely the resultant of intravascular volume excess but can also be induced by a decreased venous capacitance. This review article focusses on the pathophysiology, diagnoses, and treatment of congestion in acute heart failure. A clear distinction is made between states of volume overload (intravascular volume excess) or volume redistribution (decreased venous capacitance) contributing to congestion in acute heart failure.
ISSN:1226-3303
2005-6648
DOI:10.3904/kjim.2017.355