Acute Heart Failure Syndromes:

(Circulation. 2010;122:1975-1996.)
© 2010 American Heart Association, Inc. 

AHA Scientific Statement

Acute Heart Failure Syndromes: Emergency Department Presentation, Treatment, and Disposition: Current Approaches and Future Aims

A Scientific Statement From the American Heart Association

Neal L. Weintraub, MD, Chair; Sean P. Collins, MD, MSc, Co-Chair; Peter S. Pang, MD; Phillip D. Levy, MD, MPH;Allen S. Anderson, MD; Cynthia Arslanian-Engoren, PhD, RN, FAHA; W. Brian Gibler, MD, FAHA;James K. McCord, MD; Mark B. Parshall, PhD, RN; Gary S. Francis, MD, FAHA; Mihai Gheorghiade, MD;on behalf of the American Heart Association Council on Clinical Cardiology and Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation

Key Words: AHA Scientific Statements • acute care • diagnosis • emergency medicine • heart failure • outcomes • prognosis • treatment

	Introduction

With a prevalence of 5 800 000 (2% of the entire populace) in 2009 and an estimated yearly incidence of 550 000, the burden of heart failure (HF) in the United States is tremendous.¹ Although HF is largely a condition defined by chronic debility, virtually all patients experience, at some point, acute symptoms that trigger a visit to the emergency department (ED). These symptoms may vary in severity but, for the most part, they necessitate early intervention, often with intravenous medication and, less frequently, respiratory support. As shown by combined data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS), this is a common occurrence; there are nearly 658 000 annual ED encounters primarily for acute HF in the United States—a figure that represents almost 20% of the total HF-specific ambulatory care delivered each year.^2/.../