Korean Circ J.  2019 Jan;49(1):1-21. 10.4070/kcj.2018.0373.

KSHF Guidelines for the Management of Acute Heart Failure: Part I. Definition, Epidemiology and Diagnosis of Acute Heart Failure

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 2Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea.
  • 4Division of Cardiology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  • 6Division of Cardiology, Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 7Division of Cardiology, Department of Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. djchoi@snubh.org

Abstract

The prevalence of heart failure (HF) is on the rise due to the aging of society. Furthermore, the continuous progress and widespread adoption of screening and diagnostic strategies have led to an increase in the detection rate of HF, effectively increasing the number of patients requiring monitoring and treatment. Because HF is associated with substantial rates of mortality and morbidity, as well as high socioeconomic burden, there is an increasing need for developing specific guidelines for HF management. The Korean guidelines for the diagnosis and management of chronic HF were introduced in March 2016. However, chronic and acute heart failure (AHF) represent distinct disease entities. Here, we introduce the Korean guidelines for the management of AHF with reduced or preserved ejection fraction. Part I of this guideline covers the definition, epidemiology, and diagnosis of AHF.

Keyword

Heart failure; Guideline; Epidemiology; Diagnosis

MeSH Terms

Aging
Diagnosis*
Epidemiology*
Heart Failure*
Heart*
Humans
Mass Screening
Mortality
Prevalence

Figure

  • Figure 1 Clinical classification of acute heart failure. CI = cardiac index; PCWP = pulmonary capillary wedge pressure.

  • Figure 2 Diagnostic approach for AHF. AHF = acute heart failure; BNP = brain natriuretic peptide; CBC = complete blood count; HF = heart failure; ECG = electrocardiography; LFT = liver function test; NT-proBNP = N-terminal pro-brain natriuretic peptide; TFT = thyroid function test.

  • Figure 3 Initial management strategy for AHF. Ponikowski P, et al.; 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal 2016; 37 (27): 2129–2200, doi: 10.1093/eurheartj/ehw128. Reproduced by permission of Oxford University Press on behalf of the European Society of Cardiology. © European Society of Cardiology. AHF = acute heart failure; BiPAP = bilevel positive airway pressure; CCU = coronary care unit; CPAP = continuous positive airway pressure; ICU = intensive care unit. *Acute mechanical cause: interventricular septal perforation, ventricular free wall rupture, and acute mitral regurgitation complicating acute coronary syndrome, ii) complications due to thoracic trauma, iii) acute native or prosthetic valve dysfunction secondary to endocarditis, and iv) complications due to aortic dissection or thrombosis.

  • Figure 4 Management strategy for AHF based on the degrees of congestion and peripheral perfusion. Ponikowski P, et al.; 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal 2016; 37 (27): 2129–2200, doi: 10.1093/eurheartj/ehw128. Reproduced by permission of Oxford University Press on behalf of the European Society of Cardiology. © European Society of Cardiology. AHF = acute heart failure.


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