💔 Acute Heart Failure Profiling & Management

When to use

Use at the bedside to assign one of four hemodynamic profiles and choose targeted therapy, with general oxygen/ventilation and precipitant correction.

How it works

Warm-wet → loop diuretic + vasodilator (if SBP > 110); cold-wet → inotrope (± vasopressor) then diuresis, especially if SBP < 90; warm-dry → optimize oral drugs; cold-dry → cautious volume management.

Key points

• In hypoperfused patients, diuresis is deferred until adequate perfusion is restored, and vasodilators are avoided when SBP < 90. (original synthesis · not guideline verbatim)
• Warm-wet is the most common profile and responds to decongestion plus afterload reduction.
• Noninvasive ventilation is used for acute pulmonary edema/respiratory distress, and morphine is not routine.

References

• McDonagh TA, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021.

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