Acute Decompensated Heart Failure

Question 1

When can you say CHF is acutely decompensated?

Answer 1

when there is acute DYSPNEA (with/without pulmonary edema)

MCC - systolic or diastolic dysfunction in LEFT VENTRICLE

Question 2

Other causes of acute respiratory distress that you should rule out first

Answer 2

PE, pneumothorax, asthma, pneumonia

Question 3

How to treat acute decompensated HF

Answer 3

• o2 and ventilatory assistance with nonrebreather face mask NPPV, OR EVEN INTUBATION?
• decrease preload (diuresis) and afterload (IV nitroglycerin, a vasodilator) —-> most important
• inotropic agents in refractory pulmonary edema (like dobutamine)