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Acute and Chronic Heart Failure Overview

This document discusses acute heart failure and chronic heart failure. It defines heart failure as a clinical syndrome involving symptoms like dyspnea and decreased exercise capacity due to loss of cardiac pumping function from structural or functional heart abnormalities. It classifies heart failure based on ejection fraction and NYHA functional class. The main causes and pathophysiology of heart failure are described. The document outlines the diagnostic tools used and treatment approaches for acute heart failure, chronic heart failure with reduced ejection fraction, and chronic heart failure with preserved or mid-range ejection fraction. Initial management of acute heart failure focuses on treating congestion with diuretics while monitoring for cardiogenic shock.

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117 views40 pages

Acute and Chronic Heart Failure Overview

This document discusses acute heart failure and chronic heart failure. It defines heart failure as a clinical syndrome involving symptoms like dyspnea and decreased exercise capacity due to loss of cardiac pumping function from structural or functional heart abnormalities. It classifies heart failure based on ejection fraction and NYHA functional class. The main causes and pathophysiology of heart failure are described. The document outlines the diagnostic tools used and treatment approaches for acute heart failure, chronic heart failure with reduced ejection fraction, and chronic heart failure with preserved or mid-range ejection fraction. Initial management of acute heart failure focuses on treating congestion with diuretics while monitoring for cardiogenic shock.

Uploaded by

the author
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Acute Heart Failure

and
Chronic Heart Failure

[Link] Heriansyah [Link](K)-FIHA


FESC FAsCC

Bagian Jantung dan Pembuluh Darah Fakultas Kedokteran


Universitas Syiah Kuala
RSUD Zainoel Abidin Banda Aceh
Definition

▪ Heart failure is defined as a clinical syndrome consisting of


dyspnea, malaise, swelling and/or decreased exercise capacity
due to the loss of compensation for cardiac pumping function due
to structural and/or functional abnormalities of the heart.
▪ Heart failure is a chronic disease.

Circ J 2019; 83: 2084–2184


Classification of Heart Failure based on Ejection
Fraction (Japanese Circulation Society 2017)

Circ J 2019; 83: 2084–2184


Classification of Heart Failure based on Ejection
Fraction (European Society of Cardiology 2016)

European Heart Journal (2016) 37, 2129–2200


Stage of Heart failure and NYHA Functional Class

Circ J 2019; 83: 2084–2184


Etiology of Heart Failure

European Heart Journal (2016) 37, 2129–2200


Etiology of Heart Failure

European Heart Journal (2016) 37, 2129–2200


Pathophysiology
Pathophysiology
Pathophysiology
Pathophysiology
Pathophysiology
Diagnosis

Circ J 2019; 83: 2084–2184


Diagnosis

Circ J 2019; 83: 2084–2184


Diagnosis

▪ Laboratorium (NT-proBNP&BNP)
▪ Chest X-Ray
▪ ECG
▪ Echocardiography
▪ Cardiac MRI
▪ Cardiac CT
▪ Nuclear Imaging

European Heart Journal (2016) 37, 2129–2200


Chest X-Ray Finding

Circ J 2019; 83: 2084–2184


Diagnosis

Circ J 2019; 83: 2084–2184


Treatment HFrEF

European Heart Journal (2016) 37, 2129–2200


Treatment HFrEF

European Heart Journal (2016) 37, 2129–


2200
European Heart Journal (2016) 37, 2129–2200
Treatment may cause harm in HFrEF

European Heart Journal (2016) 37, 2129–2200


Treatment HFpEF HFmrEF

European Heart Journal (2016) 37, 2129–2200


Acute Heart
Failure
Definition

Acute Heart Failure(AHF) refers to rapid onset or worsening


of symptoms and/or signs of heart failure.

European Heart Journal (2016) 37, 2129–2200


Etiology

European Heart Journal (2016) 37, 2129–2200


Clinical Classification

European Heart Journal (2016) 37, 2129–2200


Pathophysiology
Diagnostic Measurement

European Heart Journal (2016) 37, 2129–2200


Purpose of Initial Management

Circ J 2019; 83: 2084–2184


Initial Management
Initial Management

European Heart Journal (2016) 37, 2129–2200


European Heart Journal (2016) 37, 2129–2200
Management

European Heart Journal (2016) 37, 2129–2200


Management

European Heart Journal (2016) 37, 2129–2200


Management

European Heart Journal (2016) 37, 2129–2200


Management

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Management Cardiogenic Shock in AHF

European Heart Journal (2016) 37, 2129–2200


When we transport the patient to ICCU?

Circ J 2019; 83: 2084–2184


Take Home Massage

▪ Heart failure is a chronic disease with various etiologies.


▪ Echocardiography and NT-pro BNP are recommended to diagnose
HF.
▪ Treating the congestion is main purpose of HF treatment.
▪ Diuretics are recommended to reduce the signs and symptoms of
congestion in patients with HF.
▪ ACEIs have been shown to reduce mortality and morbidity in
patients with HFrEF and are recommended unless contraindicated
or not tolerated in all symptomatic patients.
THANK YOU

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