title: Acute Decompensated Heart Failure.
abstract: Heart failure (HF) is a societal burden due to its high prevalence, frequent admissions for acute decompensated heart failure (ADHF), and the economic impact of direct and indirect costs associated with HF and ADHF. Common etiologies of ADHF include medication and diet noncompliance, arrhythmias, deterioration in renal function, poorly controlled hypertension, myocardial infarction, and infections. Appropriate medical management of ADHF in patients is guided by the identification of signs and symptoms of fluid overload or low cardiac output and utilization of evidence-based practices. In patients with fluid overload, various strategies for diuresis or ultrafiltration may be considered. Depending on hemodynamics and patient characteristics, vasodilator, inotropic, or vasopressor therapies may be of benefit. Upon ADHF resolution, patients should be medically optimized, have lifestyle modifications discussed and implemented, and medication concierge service considered. After discharge, a multidisciplinary HF team should follow up with the patient to ensure a safe transition of care. This review article evaluates the management options and considerations when treating a patient with ADHF.
authors.affiliation: 1 Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA.
authors.forename: Drayton A
authors.initials: DA
authors.lastname: Hammond
authors.affiliation: 2 Department of Pharmacy, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Melanie N
authors.initials: MN
authors.lastname: Smith
authors.affiliation: 3 Department of Pharmacy, Orlando Regional Medical Center, Orlando, FL, USA.
authors.forename: Kristen C
authors.initials: KC
authors.lastname: Lee
authors.affiliation: 4 Department of Pharmacy, Sarasota Memorial Hospital, Sarasota, FL, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Honein
authors.affiliation: 5 Department of Pharmacy, Vidant Medical Center, Greenville, NC, USA.
authors.forename: April Miller
authors.initials: AM
authors.lastname: Quidley
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents
keywords: acute decompensated heart failure; diuretic; heart failure; inotrope; vasodilator