Acute Heart Failure (AHF)or Decompansated Acute Heart
Failure (DAHF)

AHF defined as rapid or gradual onset of signs & symptoms of heart failure that result on
urgent unplanned hospitalization or Emergency Medicine Department visits. The Clinical Signs &
symptoms are significantly life threatening.
If the above features occurs in patient diagnosed with structurally heart disease categerlize as

Decompansated Acute Heart Failure (DAHF).

The cause and immediate precipitating factor(s) of the AHF must be identified and treated to
prevent further damage to the heart.

CAUSES

* Decompensation of pre-existing chronic Heart Failure eg Cardiomyopathy, Peripartum
Cardiomyopathy

* Acute Valvular Regurgitation – AR, MR 2º endocarditis, rupture of chordae tendinae

* Worsening pre-existing Valvular Disease– MS MR AR AS

* Severe Aortic Stenosis

* Hypertensive crisis

* Acute Coronary Syndrome - NSTEMI/STEMI, RV infarction, Mechanical complication of
ACS

* Acute arrhythmias – VT /VF AF/flutter or other SVTs

* Acute Severe Myocarditis

* Aortic Dissection - Acute/chronic

* Pericardial Effusion with Cardiac temponade

Precipitating factors

* Lack of Compliance with medical therapy

* Infections –Pneumonia, UTI, septicemias

* Anaemia

* Arrhythmias – Rapid AF other SVTs

* Thyroid disease – hypothyroidism

* Pulmonary Embolus

* Volume overload - iatrogenic

* Drug abuse/Alcohol – eg thiamine deficiency

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