Key result
Multidisciplinary management of acute heart failure and cardiogenic shock requires prompt initiation of oxygen therapy, vasodilators, diuretics, and early mechanical circulatory support for refractory cases.
Why the study?
Acute heart failure carries high morbidity, mortality, and economic burden across a broad spectrum of clinical presentations, requiring structured multidisciplinary guidance.
This narrative review outlines a multidisciplinary approach for the early diagnosis and management of acute heart failure and cardiogenic shock, emphasizing prompt initiation of appropriate therapies and care pathways.
Reinforces early multidisciplinary protocols in acute HF and shock; leaves open prospective validation of optimal sequences and timing.
Acute heart failure (AHF), a global pandemic with high morbidity and mortality, exerts a considerable economic burden. AHF includes a broad spectrum of clinical presentations ranging from new-onset heart failure to cardiogenic shock. Key elements of the management rely on the clinical diagnosis confirmed on, both, increased natriuretic peptides and echocardiography, and on the prompt initiation of oxygen therapy, including non-invasive positive pressure ventilation, vasodilators, and diuretics. A care pathway is essential, specifically when an acute coronary syndrome is suspected or in the case of cardiogenic shock. Association or increasing doses of vasopressors despite an adequate volume status are markers of progression toward a refractory cardiogenic shock state. For the latter, mechanical circulatory support should be initiated early, optimally before the onset of renal or liver failure. Thus, a tertiary care center is recommended for the management of patients with AHF who require percutaneous coronary intervention or mechanical circulatory support. This narrative review provides multidisciplinary guidance for the management of AHF and cardiogenic shock from pre-hospital to intensive care unit/cardiac care unit, based on contemporary evidence and expert opinion.
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Takagi et al. (2020) conducted a review in Acute heart failure and cardiogenic shock. Acute heart failure management was evaluated. Multidisciplinary management of acute heart failure and cardiogenic shock requires prompt initiation of oxygen therapy, vasodilators, diuretics, and early mechanical circulatory support for refractory cases.
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