ESC Congress 2016 - 12

FEATuREd ARTIclE Figure 7. Management of Patients During Acute Phase of Acute Heart Failure Patients with acute heart failure Bedside assesment to identify hemodynamic profiles Presence of congestion? Yes no (95% of all AHF patients) (5% of all AHF patients) 'wet' patient 'Dry' patient adequate peripheral perfusion? Yes no Yes no 'Dry and warm' patient Adequately perfused ≈ Compensated 'wet and warm' patient (typically elevated or normal systolic blood pressure) Adjust oral therapy 'Dry and warm' patient Hypoperfused, Hypovolemic Consider fluid challenge Cosider inotropic agent if still hypoperfused 'wet and cold' patient Vascular typefluid redistribution hypertension predominates * Vasodilator * Diuretic Cardiac type-fluid accumulation congestion predominates * Diuretic * Vasodilator * Ultrafiltration (consider if diuretic resistance) Systolic blood pressure < 90 mm HG Yes * Inotropic agent * Consider vasopressor in refractory cases * Diuretic (when perfusion corrected) * Consider mechanical circulatory support if no response to drugs no * Vasodilators * Diuretics * Consider inotropic agent in refractory cases AHF, acute heart failure. 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. 12 October 2016 medicom-publishers.com/mcr http://www.medicom-publishers.com/mcr

Table of Contents for the Digital Edition of ESC Congress 2016