Diagnostic & Management

Of Acute Heart Failure

Emergency for Every Doctor 2018

Dr.dr. Cindy E. Boom SpAN., KAKV., KAP

RS. Pusat Jantung dan Pembuluh Darah Nasional Harapan Kita-
Jakarta
Table. Diagnostic Criteria for Heart Failure in Population-Based Studies
Framingham Criteria

Major Criteria Minor Criteria Major or Minor Criteria

Paroxysmal nocturnal
dyspnea or orthopnea
Neck-vein distension
Rales
Cardiomegaly
Acute pulmonary edema
S3 gallop
Increased venous pressure
>6 cm H2O
Circulation time >25 sec
Hepatojugular reflux
Ankle edema, night cough Weight loss >4.5 kg in
dyspnea on exertion 5 days in response
Hepatomegaly to treatment
Pleural effusion
Vital capacity decreased
½ from maximal capacity
Tachycardia (rate>120/min)

Diagnosis of heart failure: two major, or one major and two minor criteria are required
lampiran
Goals of Treatment in Acute Heart Failure
 Chronic Symptomatic
Systolic Heart Failure

Diuretics to relieve symptoms/signs of congestion

+ ACE inhibitor (or ARB)
Titrate to clinical stability

Add a Beta-blocker

Still NYHA class II-IV?

Yes No

Add Aldosterone antagonist

Still NYHA class II-IV? No

Yes No further specific treatment

Continue in disease-management program
THANK YOU