title: Management of acute decompensated heart failure in the emergency department.
abstract: Heart failure, a disease of epidemic proportions, has a tremendous clinical and financial impact on the US health care system. With more than 5 million Americans diagnosed with heart failure and 5-year mortality approaching 50%, it is the most common cause of hospitalization in patients older than 65 years and is the single most expensive diagnosis in the US health care system. Because the average US hospital loses more than 1000 dollars per heart failure admission, effective therapies that decrease length of stay, reduce hospital costs, and prevent 30-day readmissions are needed. This article reviews the relevant pathophysiology of heart failure, discusses the newest diagnostic strategies for emergency department diagnoses, evaluates recent advances and effects of early aggressive therapies, and presents a suggested algorithm for the treatment of acutely decompensated heart failure in emergency departments.
authors.affiliation: Department of Emergency Medicine, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. peacocw@ccf.org
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: John
authors.initials: J
authors.lastname: Allegra
authors.forename: Douglas
authors.initials: D
authors.lastname: Ander
authors.forename: Sean
authors.initials: S
authors.lastname: Collins
authors.forename: Deborah
authors.initials: D
authors.lastname: Diercks
authors.forename: Charles
authors.initials: C
authors.lastname: Emerman
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Kirk
authors.forename: Randall C
authors.initials: RC
authors.lastname: Starling
authors.forename: Marc
authors.initials: M
authors.lastname: Silver
authors.forename: Richard
authors.initials: R
authors.lastname: Summers
mesh_terms: D000368:Aged; D004630:Emergencies; D004636:Emergency Service, Hospital; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D011654:Pulmonary Edema / Q000453:epidemiology