Designed and created by Guideline Central in participation with the American College of Emergency Physicians
Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department with Acute Heart Failure Syndromes
Patient Guideline Summary
Publication Date: June 23, 2022
Last Updated: March 3, 2023
This patient summary means to discuss key recommendations from the American College of Emergency Physicians (ACEP) for the critical issues in the evaluation and management of adult patients presenting to the emergency department with acute heart failure syndromes. It is limited to adults 18 years of age and older and should not be used as a reference for children.
- Acute Heart Failure occurs when the heart suddenly weakens.
- Note: Some of the most common causes of acute heart failure are heart attack, lung failure, heart valve dysfunction, severe anemia, thyroid overactivity, and heart muscle disease.
- Note: Symptoms include difficulty breathing, heart pounding, weakness, confusion, and swelling of arms, abdomen, or legs.
- This patient summary focuses on the emergency evaluation, treatment, and disposition of adults with acute heart failure.
- A medical history, physical examination, and lung ultrasound are used to diagnose acute heart failure.
- Diuretics may be used to treat volume overload.
- High-dose nitroglycerin is a safe and effective treatment for acute heart failure syndrome and elevated blood pressure.
- The Ottawa Heart Failure Risk Scale (OHFRS) and the Emergency Heart Failure Mortality Risk scores are used to determine the appropriate disposition – intensive care, hospital, or home.
- Emergency doctors will use shared decision-making to plan ongoing care.
- ACEP: American College Of Emergency Physicians
- OHFRS: Ottawa Heart Failure Risk Scale
American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Acute Heart Failure Syndromes. Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Heart Failure Syndromes: Approved by ACEP Board of Directors, June 23, 2022. Ann Emerg Med. 2022 Oct;80(4):e31-e59. doi: 10.1016/j.annemergmed.2022.05.027. PMID: 36153055.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.