Acute decompensated heart failure

Introduction Acute decompensated heart failure (ADHF) describes a set of clinical syndromes characterized by reduced cardiac output secondary to impaired ventricular function. Impaired ventricular function can be caused by new pathology (i.e. as myocardial infarction), or exacerbation of an underlying chronic process (Table 24.1). Heart failure can generally be classified on the basis of the cardiac cycle (systolic or diastolic heart failure), or by which ventricle is predominantly impaired (left-or right-sided heart failure). Less frequently, patients may develop high-output heart failure which is associated with low systemic vascular resistance and above-normal cardiac index.