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e-Article

Early Management of Patients With Acute Heart Failure: State of the Art and Future Directions. A Consensus Document From the Society for Academic Emergency Medicine/Heart Failure Society of America Acute Heart Failure Working Group
Document Type
article
Source
Journal of Cardiac Failure. 21(1)
Subject
Biomedical and Clinical Sciences
Cardiovascular Medicine and Haematology
Clinical Sciences
Emergency Care
Clinical Research
Health Services
Aging
Cardiovascular
Heart Disease
Acute Disease
Consensus
Disease Management
Emergency Medicine
Forecasting
Heart Failure
Humans
Randomized Controlled Trials as Topic
Societies
Medical
Time Factors
United States
Acute heart failure
emergency medicine
early management
SAEM/HFSA Acute Heart Failure Working Group
Cardiorespiratory Medicine and Haematology
Nursing
Cardiovascular System & Hematology
Cardiovascular medicine and haematology
Clinical sciences
Language
Abstract
Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition decisions cannot be underestimated. Predictive instruments that identify a cohort of patients safe for ED discharge, while simultaneously addressing barriers to successful outpatient management, have the potential to significantly impact quality of life and resource expenditures.