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.
Collins SP, Levy PD, Martindale JL, Dunlap ME, Storrow AB, Pang PS, Albert NM, Felker GM, Fermann GJ, Fonarow GC, Givertz MM, Hollander JE, Lanfear DJ, Lenihan DJ, Lindenfeld JM, Frank Peacock W, Sawyer DB, Teerlink JR, Butler J. 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. Acad Emerg Med. 2016 Aug;23(8):922-31.
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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.
Medical Subject Headings
Acute Disease; Advisory Committees; Aged; Biomedical Research; Consensus; Diuretics; Dose-Response Relationship, Drug; Emergency Medicine; Emergency Service, Hospital; Female; Heart Failure; Humans; Hypertension; Male; Societies, Medical