Title

Clinical and Research Considerations for Patients With Hypertensive Acute Heart Failure: A Consensus Statement from the Society for Academic Emergency Medicine and the Heart Failure Society of America Acute Heart Failure Working Group.

Document Type

Article

Publication Date

8-2016

Institution/Department

Medical Education

Journal Title

Academic Emergency Medicine

MeSH Headings

Hypertension Diagnosis; Heart Failure Diagnosis; Medical Organizations; Emergency Medicine; Human; Acute Disease; Heart Failure Physiopathology; Heart Ventricle, Left Physiology; Age Factors; Heart Failure Therapy; Nitroglycerin Administration and Dosage; Transdermal Patches, Drugs; Diuretics; Calcium Channel Blockers; Angiotensin-Converting Enzyme Inhibitors Administration and Dosage; Angiotensin II Type I Receptor Blockers

Abstract

Management approaches for patients in the emergency department ( ED) who present with acute heart failure ( AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume overload. Patients with hypertensive AHF (H- AHF) represent a clinical phenotype with distinct pathophysiologic mechanisms that result in elevated ventricular filling pressures. To optimize treatment response and minimize adverse events in this subgroup, we propose that clinical management be tailored to a conceptual model of disease that is based on these mechanisms. This consensus statement reviews the relevant pathophysiology, clinical characteristics, approach to therapy, and considerations for clinical trials in ED patients with H- AHF.

First Page

922

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