Clinical and Research Considerations for Patients With Hypertensive Acute Heart Failure: A Consensus Statement from the Society for Academic Emergency Medicine and the Heart Failure Society of America Acute Heart Failure Working Group.

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Abstract

Management approaches for patients in the emergency department (ED) who present with acute heart failure (AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume overload. Patients with hypertensive AHF (H-AHF) represent a clinical phenotype with distinct pathophysiologic mechanisms that result in elevated ventricular filling pressures. To optimize treatment response and minimize adverse events in this subgroup, we propose that clinical management be tailored to a conceptual model of disease that is based on these mechanisms. This consensus statement reviews the relevant pathophysiology, clinical characteristics, approach to therapy, and considerations for clinical trials in ED patients with H-AHF.

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Journal

Journal ID (iso-abbrev): Acad Emerg Med

Title: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

Publisher: Wiley-Blackwell

ISSN (Electronic): 1553-2712

ISSN (Print): 1069-6563

Publication date (Electronic): Aug 2016

Volume: 23

Issue: 8

Affiliations

[1 ] Department of Emergency Medicine, Vanderbilt University, Nashville, TN.

[2 ] Department of Emergency Medicine, Wayne State University, Detroit, MI.

[3 ] Department of Emergency Medicine, SUNY Downstate, Brooklyn, NY.

[4 ] Department of Medicine, Case Western University, Cleveland, OH.

[5 ] Department of Emergency Medicine, Indiana University, Indianapolis, IN.

[6 ] Department of Medicine, Cleveland Clinic, Cleveland, OH.

[7 ] Department of Medicine, Duke University, Durham, NC.

[8 ] Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH.

[9 ] Department of Medicine, University of California at Los Angeles, Los Angeles, CA.

[10 ] Department of Medicine, Harvard Medical School, Boston, MA.

[11 ] Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA.

[12 ] Department of Medicine, Henry Ford Health System, Detroit, MI.

[13 ] Department of Medicine, Vanderbilt University, Nashville, TN.

[14 ] Department of Emergency Medicine, Baylor College of Medicine, Houston, TX.

[15 ] Department of Medicine, Maine Medical Center, Portland, ME.

[16 ] Department of Medicine, San Francisco VA Medical Center, San Francisco, CA.

[17 ] Department of Medicine, Stony Brook University, Stony Brook, NY.

Article

DOI: 10.1111/acem.13025

PubMed ID: 27286136

SO-VID: f7a6670e-ca97-43b2-b0ff-beaaab577763

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