Heart failure: an analysis of the management of decompensated patients in the emergency room

Abstract

Heart failure (HF) is a complex clinical condition characterized by the inability of the heart to maintain adequate blood flow to satisfy the metabolic needs of tissues or to maintain central venous pressure at normal levels, without excessive volumetric overload. The treatment of heart failure (HF) in the emergency room setting is a critical and intensive approach that aims to immediately stabilize the patient, alleviate acute symptoms, and correct hemodynamic and metabolic imbalances. This systematic review analyzed articles on emergency heart failure management published in the last 5 years. The databases PubMed, LILACS, Periódicos CAPES, EMBASE and Scielo were searched, using the descriptors “Heart failure” and “Emergency room”. Studies on humans or animals in Portuguese, English and Spanish were included. After filtering duplicates and irrelevant articles, 5 studies were selected for analysis. Thus, study findings suggest that intensive therapeutic strategies, early use of empagliflozin and dapagliflozin, and implementation of structured decision support approaches can significantly improve clinical outcomes in patients with AHF. However, there is a need for more research to deepen the understanding of interactions between different therapies, over the long term and in diverse populations, to further optimize management strategies and maximize benefits for patients. Additional studies are needed to validate the effectiveness of these treatments in different clinical scenarios and evaluate their implications for long-term management practices.