Heart failure is one of the most common causes of hospitalization in the U.S., particularly in patients over the age of 70. Some of these patients are critically ill, while others simply need minor medication adjustments before being discharged.

Matthew Strehlow, MD, FACEP

The situation of individual patients can be complicated to assess, said Matthew Strehlow, MD, FACEP, clinical associate professor, emergency medicine, Stanford University, Stanford, California. So in his session “Acute Decompensated Heart Failure: Time Critical Interventions,” Dr. Strehlow will review the assessment of heart failure and several treatments for it.

The session will cover treatments that have an impact on survival in heart failure patients. For example, research has found that noninvasive positive pressure ventilation is beneficial in heart failure patients. “It can save patients from being intubated, and it can save their lives,” he said.

Another treatment that will be discussed is the need for reload reduction, including the use of vasodilators to reduce stress and strain on the heart.

Dr. Strehlow plans to address some areas where heart failure care in the emergency department can improve, including:

• The use of bedside ultrasound to determine if a patient has heart failure (Tip: “The take-home is that you should be looking for B-lines in the patient’s lungs rather than focusing on what the lungs look like,” Dr. Strehlow said.)
• Assessing volume overload—“You classically think of patients being volume overloaded, but that’s incorrect in 25 to 50 percent of cases,” he said. “Sometimes, a patient may actually be volume down, and it’s just a matter of shifting volume to a different spot.”

Vanessa Caceres is a freelance medical writer based in Florida.