258C - ADHF Management

Question 1

Prognosis of ADHF

Answer 1

50% re-admissions within 6 months
5% short term (in-hospital) mortality
20% long term cardiovascular mortality at 1 year

Question 2

Causes/precipitating factors of acute decompensation of heart failure

Answer 2

1. Non-compliance to medication
2. Dietary salt or fluid indiscretion
3. Acute illness, infection or inflammation
4. New medications: NSAIDs, thiazolidinediones, TNF-i, anti-depressants, cancer therapies, flu meds with cardiac stimulants
5. Pulmonary embolism
6. Arrhythmias

Question 3

What are the parameters associated with worse outcomes in ADHF?

Answer 3

1. Urea > 15 mmol/L
2. Creatinine > 243 umol/L
3. SBP < 115mmHg
4. Elevated cardiac biomarkers - troponin, BNP