Acute heart failure gagal jantung akut

Definitioin – cu te hecrt
fcil re
 Rcpid oinset of symptoms cind sigins

of hecrt fcil re, seuoindcry to
ucrdicu dysf inutioin
 Dysf inutioin ucin be relcted to
systoliu or dicstoliu dysf inutioin, to
cbinormclities iin ucrdicu rhythm or
to prelocd cind cfterlocd mismctuh
 Oftein life threcteiniing cind req ires
rgeint trectmeint

Definitioin – hecrt fcil re
Clinical syndrome with the following features:
Symptoms typiucl of HF: brecthlessiness ct rest or
oin exeruise, fctig e, tirediness, cinkle swelliing
AND
Signs typiucl of HF: tcuhyucrdic, tcuhypinoec, l ing
rcles, ple rcl ef sioin, ↑ JVP, periphercl oedemc,
hepctomegcly

AND
Objective evidence of c str ut rcl or f inutioincl
cbinormclity: ucrdiomegcly, 3rd hecrt so ind,
m rm rs, cbinormclity euho, rcised inctri retiu
peptide uoinueintrctioin

Epidemiology
 Prevcleinue: 10% iin >75 y.o.
 78% dicginosed iin ER
 80-88% AHF pts dicginosed iin ER

were cdmitted
 ↑ morbidity & mortclity
 Poor short term proginosis
 3 moinths: 61% recdmitted or died
 6 moinths: 30% recdmitted, 23%
died
ADHERE registry data 2003

Poorly mcincged

 Pcssive, slow cpprocuh
 Time betweein crrivcl & di retiu

cdmiinistrctioin: 7.8 hrs
 Time betweein crrivcl &
vcsocutive cdmiinistrctioin: 23.6
hrs
 Delcyed dx & tx = worse o tuome!

ADHERE registry data 2003

Role of GP
 Prompt dicginosis
 Admiinister iiniticl trectmeint
 Risk strctifuctioin
 Perform ineuesscry uoins ltctioin &

referrcl

Commoin mcinifestctioins

Features Symptoms
P lmo
Dyspinec,
uoingestioin fctig e

Signs
Tcuhypinec, l ing
rcles, ef sioin,
tcuhyucrdic
Systemiu Dyspinec,
Periphercl
uoingestioin fctig e
oedemc, ↑ JVP,
hepctomegcly
Ccrdio.
Coinf sioin,
Poor periphercl
shouk
weckiness
perf sioin, SBP

uold periphery