title: Summary of the II Brazilian Guideline update on Acute Heart Failure 2009/2011.
abstract: In the past two years we observed several changes in the diagnostic and therapeutic approach of patients with acute heart failure (acute HF), which led us to the need of performing a summary update of the II Brazilian Guidelines on Acute Heart Failure 2009. In the diagnostic evaluation, the diagnostic flowchart was simplified and the role of clinical assessment and echocardiography was enhanced. In the clinical-hemodynamic evaluation on admission, the hemodynamic echocardiography gained prominence as an aid to define this condition in patients with acute HF in the emergency room. In the prognostic evaluation, the role of biomarkers was better established and the criteria and prognostic value of the cardiorenal syndrome was better defined. The therapeutic approach flowcharts were revised, and are now simpler and more objective. Among the advances in drug therapy, the safety and importance of the maintenance or introduction of beta-blockers in the admission treatment are highlighted. Anticoagulation, according to new evidence, gained a wider range of indications. The presentation hemodynamic models of acute pulmonary edema were well established, with their different therapeutic approaches, as well as new levels of indication and evidence. In the surgical treatment of acute HF, CABG, the approach to mechanical lesions and heart transplantation were reviewed and updated. This update strengthens the II Brazilian Guidelines on Acute Heart Failure to keep it updated and refreshed. All clinical cardiologists who deal with patients with acute HF will find, in the guidelines and its summary, important tools to help them with the clinical practice for better diagnosis and treatment of their patients.
authors.affiliation: Hospital Pró Cardíaco, RJ, Brazil.
authors.forename: Marcelo Westerlund
authors.initials: MW
authors.lastname: Montera
authors.forename: Sabrina Bernardez
authors.initials: SB
authors.lastname: Pereira
authors.forename: Alexandre Siciliano
authors.initials: AS
authors.lastname: Colafranceschi
authors.forename: Dirceu Rodrigues de
authors.initials: DR
authors.lastname: Almeida
authors.forename: Evandro Mesquita
authors.initials: EM
authors.lastname: Tinoco
authors.forename: Ricardo Mourilhe
authors.initials: RM
authors.lastname: Rocha
authors.forename: Lídia Ana Zytynski
authors.initials: LA
authors.lastname: Moura
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Réa-Neto
authors.forename: Sandrigo
authors.initials: S
authors.lastname: Mangini
authors.forename: Fabiana Goulart Marcondes
authors.initials: FG
authors.lastname: Braga
authors.forename: Denilson Campos
authors.initials: DC
authors.lastname: Albuquerque
authors.forename: Edson
authors.initials: E
authors.lastname: Stefanini
authors.forename: Eduardo Benchimol
authors.initials: EB
authors.lastname: Saad
authors.forename: Fábio
authors.initials: F
authors.lastname: Vilas-Boas
authors.forename: Fabrício Braga da
authors.initials: FB
authors.lastname: Silva
authors.forename: Felix José Alvarez
authors.initials: FJ
authors.lastname: Ramires
authors.forename: Francisco Garcia
authors.initials: FG
authors.lastname: Soriano
authors.forename: Glauco
authors.initials: G
authors.lastname: Westphal
authors.forename: Gustavo Calado de
authors.initials: GC
authors.lastname: Aguiar Ribeiro
authors.forename: Gustavo Luiz Gouvêa de
authors.initials: GL
authors.lastname: Almeida Júnior
authors.forename: Humberto
authors.initials: H
authors.lastname: Villacorta Júnior
authors.forename: João David de
authors.initials: JD
authors.lastname: Souza Neto
authors.forename: João Luiz Ferreira
authors.initials: JL
authors.lastname: Costa
authors.forename: João Manoel Rossi
authors.initials: JM
authors.lastname: Neto
authors.forename: Luciano Moreira
authors.initials: LM
authors.lastname: Baracioli
authors.forename: Luís
authors.initials: L
authors.lastname: Beck da Silva Neto
authors.forename: Luiz Eduardo
authors.initials: LE
authors.lastname: Camanho
authors.forename: Marcelo Imbroinise
authors.initials: MI
authors.lastname: Bittencourt
authors.forename: Marcelo Iório
authors.initials: MI
authors.lastname: Garcia
authors.forename: Maria da
authors.initials: Md
authors.lastname: Consolação Vieira Moreira
authors.forename: Rachel Duarte
authors.initials: RD
authors.lastname: Moritz
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gusmão
authors.forename: Silvia Marinho
authors.initials: SM
authors.lastname: Martins
authors.forename: Solange
authors.initials: S
authors.lastname: Bordignon
authors.forename: Alfredo Inacio
authors.initials: AI
authors.lastname: Fiorelli
mesh_terms: D000208:Acute Disease; D001938:Brazil; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D006801:Humans