Acute decompensated heart failure

Acute Decompensated Heart Failure (ADHF) is a sudden worsening of the symptoms of heart failure, which is a condition where the heart is unable to pump blood efficiently to meet the body's needs. ADHF is a medical emergency that requires immediate attention and treatment to prevent life-threatening complications.

Causes

The causes of ADHF can be categorized into factors that increase the heart's workload (such as hypertension and valvular heart disease), factors that impair the heart's pumping ability (such as myocardial infarction and cardiomyopathy), and factors that decrease the heart's filling (such as arrhythmias and pericardial effusion).

Symptoms

Common symptoms of ADHF include dyspnea (shortness of breath), orthopnea (difficulty breathing while lying flat), paroxysmal nocturnal dyspnea (sudden nighttime shortness of breath), cough with frothy sputum, fatigue, edema (swelling), and weight gain due to fluid retention.

Diagnosis

Diagnosis of ADHF involves a combination of medical history, physical examination, and diagnostic tests. Key tests include echocardiography to assess heart function, electrocardiogram (ECG) to identify heart rhythm problems, and blood tests to measure levels of natriuretic peptides which are markers of heart failure.

Treatment

Treatment of ADHF aims to improve symptoms, stabilize the patient's condition, and address the underlying cause of the heart failure. Initial management often includes supplemental oxygen, diuretics to remove excess fluid, and medications to improve heart function such as angiotensin-converting enzyme inhibitors (ACE inhibitors), beta blockers, and angiotensin receptor blockers (ARBs). In severe cases, mechanical support devices or surgery may be required.

Prognosis

The prognosis of ADHF varies depending on the underlying cause, the severity of symptoms, and the patient's overall health. Early diagnosis and treatment are crucial for improving outcomes.

Prevention

Prevention of ADHF involves managing risk factors for heart failure, such as controlling high blood pressure, maintaining a healthy weight, avoiding tobacco, and managing diabetes.