Insuficiencia cardíaca aguda

Acute heart failure (AHF) is a severe condition that requires urgent care, with high mortality and readmission rates. It mainly affects older adults and can occur de novo or as decompensation of chronic heart failure. It is a complex clinical syndrome with multiple pathogenic mechanisms that include cardiac and extracardiac factors. It can be triggered by ischemia, hypertension, arrhythmias, or infections. In addition, cardiac function and peripheral vasculature play key roles in its pathophysiology. It mainly presents with signs of congestion or peripheral hypoperfusion with four clinical forms: acute decompensation of heart failure, acute pulmonary edema, isolated right ventricular failure, and cardiogenic shock. Diagnosis is based on physical examination and additional tests such as an electrocardiogram (ECG), echocardiography, and biomarker analysis (BNP, NT-proBNP). Treatment of AHF focuses on relieving congestion and improving peripheral perfusion, identifying and treating triggers and optimizing long-term treatments. It includes diuretics, vasodilators, and vasoconstrictors to improve perfusion and inotropics to improve cardiac function when necessary.