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1、本【人民生让二:el张”健人AHF 指心衰症状和体征突然发作或恶化，需要紧急医疗处置和住院治疗的、危及生命的紧急情况。人AHF 既往亚的恶化，可以是HF-REF 或是 HEF-PEFAHF 首次发作的HEF (“de novo” AHF)机8训引轩下二六攻开训作引内隐和号下5显的诱因，如: 感染、心律失常、HF-REF者中止利尿剂治疗或容量超负荷、严重的高血压患者发生HF-PEF 机下本加有和数小时或数分钟内加重的E，如: AMI时;患者的症状是一个谱样的变化，从严重呼吸困难、危及生命的肺水肿和/或心原性休克 Hypertensive AHF SS慢性心衰恶化或失代偿肺水肿1车孤立性右心衰0组
2、间的重又| 和N2:上 Events usually leading to rapid deterioration infarction)intervyentricular septum, mitral valve chordal rupcure,right ventricular*Rapid arrhythmia or severe bradycardia/conduction disturbance*“ Acute coronary Syndrome 皮*Mechanical complication of acute coronary Syndrome (eg.rupture of 中
3、,Acute pulmonary embolism Events usualy leading to less rapid deterioration * Hypertensive crisis*Cardiac amponadeAortic dissection * Peripartum cardiomyopathy ， Infection (including infective endocarditis) 1Exacerbation of COPDlasthma ”Anaenia *Surgery and perioperative problemsKidney dysfunctionNo
4、n-adherence to dieudrug herapy ， htrogenic causes (eg.prescription of an NSAID or corticosteroid;drug interactions) “Arrhythmias bradycardia and conduction disturbances not leading tosudden severe change in heart rate 。Uncontrolled bypertension *Hypodyroidsm or byperthyroidism * Alcohol and drug abu
5、se :三区5 认|对于发生AHF的患者首先要同时评估三个问题全 党全站2如果患者是HF，是否症状来的突然，而需要紧急处置，如: 心律失常或ACS?过3 是重要脏器低灌注心、脑、肾) 厨 村由工区* 治疗目标: 纠正缺O，二宇让 友2半2图 增加SV 一改善动脉供血* 治疗原则:ER机Suspected acute heart failureHistorylexamination(including blood pressure and respiratory rate) Chest X-ray ECGEchocardiogram or NP (or both) Oxygen saturati
6、onBlood chemistry Full blood countVendtlon/ Ufe-threatening Blood pressure Acute AcuteSystemlc arrhythmia/ 85 mmHg coronary mechanlcaloxygenation bradycarda? orshodk Syndromet Causelsevereinadequatem vavular diseaser| | | 1 |省 由 YY 六 十,Oxygen ,Electrial Inotropel Coronary ,Echoaardiography,NIV Cardi
7、overslon vasopressor reperfusion Surglcaal.ETTand ,Padng Mechanical ,Antithrombouc ， percutaneousinvasive airculatory therapy Interventionventllation Support(eg.IABP) Yes NoSevere anxiegyjdistress se | Consider iv opiateNe Measure systolic blood pressure SBp 1l0 mmHgAdd non-vasodiating inotropet sae
8、daras Consider vsodiator (eg NTG9 Contnue present beament Re-emaluation of padents clinical satusl No NoSBp 85 mmHe SpO 90% Unine ouput 20mUhi和 和Stop msodiator | OOggenl | ，Bhdder catheteriation to confirm,Stop bea-blodkerif Mypoperfused ,Consider NV5 ,ncrease dose of diuretic or use,Consider nonrmsodiatnginomope ,Consider ETTand combmation ofdiuretics7or vasopressort invasive ventibtion ，Consider low-dose dopami,Consider riheheart aatheterization ,Consider rhchear catheterization,Consder mechanical circuhtory ,Consider unaflnauon?Support -
