Overview
Acute heart failure (AHF) is a sudden, rapid decline in heart function, leading to inadequate blood flow to meet the body's needs. It is a life-threatening condition that requires immediate medical attention.
Unlike chronic heart failure, which develops gradually, acute heart failure can occur suddenly, often as a result of a heart attack, severe high blood pressure, or other acute cardiac events. Recognizing the signs early and seeking emergency care can save lives.
Symptoms
Common symptoms of acute heart failure include:
- Sudden shortness of breath (dyspnea), especially when lying flat
- Swelling (edema) in the legs, ankles, and feet
- Fatigue and weakness
- Rapid or irregular heartbeat (palpitations)
- Chest discomfort or pain
- Wheezing or a persistent cough, sometimes with pink, frothy mucus
- Sudden weight gain from fluid retention
- Confusion or difficulty concentrating
- Loss of appetite and nausea
Note: These symptoms can develop rapidly. If you or someone else experiences these signs, call emergency services immediately.
Causes
Acute heart failure can be triggered by various conditions that stress the heart, including:
- Heart attack (myocardial infarction) — damage to the heart muscle
- Severe high blood pressure (hypertensive crisis)
- Heart valve disease (e.g., mitral or aortic valve issues)
- Arrhythmias (abnormal heart rhythms)
- Cardiomyopathy (disease of the heart muscle)
- Pulmonary embolism (blood clot in the lungs)
- Severe infection or inflammation of the heart (myocarditis)
- Excessive fluid or salt intake in patients with underlying heart conditions
In many cases, acute heart failure occurs in people with pre-existing heart disease, but it can also be the first presentation of a cardiac problem.
Treatment
Acute heart failure is a medical emergency. Treatment focuses on stabilizing the patient, improving heart function, and relieving symptoms. Common interventions include:
- Oxygen therapy to improve breathing and oxygen levels
- Diuretics (water pills) to remove excess fluid and reduce swelling
- Vasodilators to widen blood vessels and reduce the workload on the heart
- Inotropes to strengthen the heart's contractions
- Medications to control blood pressure and heart rate
- Mechanical support (e.g., intra-aortic balloon pump) in severe cases
- Addressing the underlying cause (e.g., treating a heart attack or arrhythmia)
Long-term management may include lifestyle changes, cardiac rehabilitation, and ongoing medication to prevent recurrence.