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Non-pharmacological therapy of acute heart failure: when drugs alone are not enough 

Non-pharmacological therapy of acute heart failure: when drugs alone are not enough
Chapter:
Non-pharmacological therapy of acute heart failure: when drugs alone are not enough
Author(s):

Pascal Vranckx

, Wilfried Mullens

, and Johan Vijgen

DOI:
10.1093/med/9780199687039.003.0053

February 22, 2018: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

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date: 07 December 2019

Acute heart failure syndrome has been defined as new-onset or a recurrence of worsening signs and symptoms of heart failure, necessitating urgent or emergency management. The management of acute heart failure syndrome is challenging, given the heterogeneity of the patient population, in terms of the clinical presentation, pathophysiology, prognosis, and therapeutic options. The management of acute heart failure syndrome is a dynamic process, requiring ongoing simultaneous diagnosis (monitoring) and treatment. Pharmacological agents remain the mainstay of therapy for acute heart failure syndrome. However, at all time, during the early diagnostic, aetiologic, and therapeutic work-up, non-pharmacologic therapy may be indicated and should be considered. The management of the complex cardiac patient with acute heart failure syndrome and/or (potential) haemodynamic compromise has become a special dimension for specialized myocardial intervention centres, providing 24 hours per day and 7 days per week state-of-the-art facilities for (primary) percutaneous coronary intervention and cardiac intensive care, including mechanical ventilation, ultrafiltration, with or without dialysis, and short-term percutaneous mechanical circulatory support. Through the understanding of the underlying pathophysiology and approaches into the problems of acute heart failure syndrome, one should be better prepared to understand and treat its many facets.

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