October 27, 2026European Journal of Emergency Medicine
The 2026 ESC Heart Failure Guidelines: what is new and what is left for the emergency physician?
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“The guidelines also favor the term “decompensated heart failure” over “acute heart failure,” reinforcing the concept that clinical deterioration often reflects an evolving process rather than an abrupt event. These changes provide a clearer and more actionable clinical pathway and emphasize rapid initiation of foundational therapies and timely referral for advanced heart failure care.”
DMDr. Muthiah Vaduganathan
“FMT now includes SGLT2 inhibitors and mineralocorticoid receptor antagonists (MRAs) for all patients with heart failure regardless of ejection fraction. ACE inhibitors, angiotensin receptor-neprilysin inhibitors or angiotensin receptor blockers, and beta-blockers are added for HFrEF.”
DMDr. Michael Fu
“The 2026 ESC guidelines for heart failure aim to simplify care and promote earlier treatment and prevention. Patients with mildly reduced left ventricular ejection fraction are now grouped with heart failure with reduced ejection fraction, which may streamline therapy choices.”
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Miró et al. (2026) studied this question.