title: Management of acute heart failure in the emergency department.
abstract: Acute heart failure (AHF) is a leading cause of hospital admission in the UK and is associated with significant mortality. The National Institute for Health and Care Excellence ( 2014 ) has published guidelines for the management of AHF but, after a clinical event in which a patient's management differed from that recommended in the guidelines occurred in the author's emergency department, he conducted a critical analysis of them. This article provides a case study of the clinical event, reviews the treatment methods adopted and explores the rationale for taking a different approach from that recommended in the guidelines. The evidence base for the use of diuretics, nitrates and non-invasive ventilation in the management of patients with AHF is also appraised.
authors.affiliation: Emergency department, Heart of England NHS Foundation Trust.
authors.forename: Rob
authors.initials: R
authors.lastname: Fenwick
mesh_terms: D000208:Acute Disease / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011654:Pulmonary Edema / Q000175:diagnosis* / Q000628:therapy*; D035703:Therapies, Investigational / Q000379:methods*; D006113:United Kingdom
keywords: acute heart failure; congestive cardiac failure; emergency care; left ventricular failure; pulmonary oedema