Author/Editor     Gričar, Marko
Title     Klasično zdravljenje akutnega popuščanja srca - pregled, možnosti in omejitve
Translated title     Current therapies for acute heart failure - overwiev, options, and limitations
Type     članek
Source     In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja. Zbornik 12. mednarodni simpozij o urgentni medicini; 2005 jun 15-18; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year     2005
Volume     str. 32-7
Language     slo
Abstract     Acute heart failure can be a first manifestation or an exacerbation of chronic heart failure precipitated by different conditions. It is always a life threatening condition. Therapy must be quick and efficient and drugs are not always identical to those used in management of chronic heart failure. The drugs do not necessarily influence long-term prognosis and mortality but help to overcome the crisis. It is often necessary to use drugs that increase systemical vascular resistence in order to achieve sufficient perfusion of vital organs even though therapy in heart failure usualy aims at reduction of sympathetic activity. It is generally important to improve myocardial contractility and reduce afterload. Classical drugs used in management of acute pulmonary edema are oxygen, diuretics, morphine, antiemetics, nitrates. Sometimes inotropes, vasopresors, inodilators and nonpharmacologic measures have to be added. Severe cases require aortic baloon counterpulsation, cardiac resynchronisation therapy, surgical procedures, implantation of ICDs, and finally heart transplantation as the last resort. New perspectives can be percieved in methods of noninvasive ventilation (CPAP mask) that can prevent the need for intubation, new drugs such as the calcium sensitizer levosimendan, broader availability of aortic baloon counterpulsation, and in implementation of devices such as left ventricular assist device
Descriptors     HEART FAILURE, CONGESTIVE
PULMONARY EDEMA