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Acute heart failure: early pharmacological therapy 

Acute heart failure: early pharmacological therapy
Acute heart failure: early pharmacological therapy

Jonathan R Dalzell

, Colette E Jackson

, Roy Gardner

, and John JV McMurray



The addition of the only fully published RCT of AHF therapy since the last edition (TRUE-AHF). This was a negative trial. As such, the updated ESC guidelines in 2016 were not significantly different to the 2012 guidelines.

Figures from the first edition of our chapter that were taken from the 2012 ESC guidelines that are not repeated in the 2016 ESC guidelines have been removed.

Modified 1 Table

2 new Futher Readings, deleted 1

5 new references, deleted 5

Updated on 22 February 2018. The previous version of this content can be found here.
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date: 09 July 2020

Acute heart failure syndromes consist of a spectrum of clinical presentations due to an impairment of some aspect of the cardiac function. They represent a final common pathway for a vast array of pathologies and may be either a de novo presentation or, more commonly, a decompensation of pre-existing chronic heart failure. Despite being one of the most common medical presentations, there are no definitively proven prognosis-modifying treatments. The mainstay of current therapy is oxygen and intravenous diuretics. However, within this spectrum of presentations, there is a crucial dichotomy which governs the ultimate treatment approach, i.e. the presence, or absence, of cardiogenic shock. Patients without cardiogenic shock may receive vasodilators, whilst shocked patients should be considered for treatment with inotropic therapy or mechanical circulatory support, when appropriate and where available.

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