BEDSIDE DIAGNOSTIC OF ACUTE HEART FAILURE : STATE OF ART !

I Nyoman Gede Sudiarta

Departement of Cardiology and Vascular Medicine,

BRSU Tabanan, Bali

Abstract

Heart failure presents a particularly difficult public health challenge and remains a major
cause of mortality, morbidity, and poor quality of life. Compared to chronic heart failure, there is
less robust evidence to guide diagnosis, risk stratification and management Acute Heart Failure
(AHF). Despite its high prevalence in the emergency setting, the diagnosis of AHF in ED patients
can be challenging.

Acute heart failure is a syndrome defined as the new onset or worsening of symptoms and
signs of HF, mostly related to systemic congestion. In the presence of an underlying structural or
functional cardiac dysfunction, one or more precipitating factors can induce AHF.

The pathophysiology of AHF is highly heterogeneous. Fluid retention and redistribution

result in pulmonary and systemic congestion, eventually causing organ dysfunction due to
hypoperfusion. Each of these two forms of congestion has a different pathophysiology and
requires a different diagnostic approach.

History and physical examination is important. however, physical examination findings

are often not sensitive or specific. Emergency assessments may include electrocardiogram, chest
radiograph, echocardiography, additional laboratory test, combined with clinical assessment and
gestalt, are recommended.

This state of the art review aims to summarize diagnostic acute heart failure. Evaluation
of patients with AHF is critical for the appropriate selection and monitoring of therapy as well as
for the prevention of recurrent hospitalizations.

Keywords : Acute Heart Failure, Diagnostic, Congestion