ESC Congress 2016 - 11

Your FREE access to ESC Congress content all year long www.escardio.org/365 ESC CONGRESS 2016 IN REVIEW Regular aerobic exercise is recommended for patients with HF to improve functional capacity and symptoms and in stable patients with HFrEF to reduce the risk of HF hospitalization. The guidelines recommend that patients with HF be enrolled in a multidisciplinary care management program to reduce the risk of HF hospitalization and mortality. The diagnosis and treatment of patients with acute HF (AHF) should be accomplished as quickly as possible. The algorithm for the initial management of AHF is shown in Figure 6. The guidelines recommend applying an algorithm based on clinical profiles evaluating the presence of congestion and peripheral hypoperfusion for optimal management during the early phase of AHF (Figure 7). Upon discharge, patients with AHF should be enrolled in a disease management program. They should be seen by a general practitioner within 1 week of discharge and by the hospital cardiology team within 2 weeks of discharge. Figure 6. Initial Work-Up of Patient With Acute Heart Failure Patient with suspected AHF Urgent phase after first medical contact 1. Cardiogenic shock ? Circulatory support * pharmacological * mechanical yes no 2. Respiratory failure ? Ventilatory support * oxygen * NIPPV (CPAP, BiPAP) * mechanical ventilation yes no Immediate phase (initial 60-120 minutes) Immediate stabilization and transfer to ICU/CCU C H A M P Identification of acute aetiology: acute Coronary syndrome Hypertensive emergency Arrhythmia acute Mechanical cause Pulmonary embolism yes no Diagnostic work-up to confirm AHF Clinical evaluation to select optimal management Immediate initiation of specific treatment Follow detailed recommendations in the specific ESC guidelines AHF, acute heart failure; BiPAP, bilevel positive airway pressure; CCU, cardiac care unit; CPAP, continuous positive airway pressure; ESC, European Society of Cardiology; HF, heart failure; ICU, intensive care unit; NIPPV, noninvasive positive pressure ventilation. Reprinted from Ponikowski P et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur J Heart Fail. 2016; 37: 2129-2200. doi:10.1093/eurheartj/ehw128. By permission of John Wiley & Sons on behalf of the European Society of Cardiology. Official Peer-Reviewed Highlights From ESC Congress 2016 11 http://www.escardio.org/365

Table of Contents for the Digital Edition of ESC Congress 2016