L'insuffisance cardiaque aiguë aux urgences

Although frequently encountered in the emergency department, acute heart failure remains a challenge for clinicians. Clinical signs and symptoms can be misleading and therefore final diagnosis often relies on biomarkers and echocardiography. Initial therapy is focused on relief of symptoms and hemodynamic stabilization concomitantly with specific treatment of a precipitating factor. Yet, treatment principles and key drugs haven't changed for years and still rely on diuretics for fluid removal according to volume status, vasodilators as first-line therapy in acute pulmonary oedema, oxygen or ventilation if necessary, and inotropes or vasopressors in case of systemic hypoperfusion or cardiogenic shock. Despite of well-established predictors of adverse events, risk stratification remains poor and leads to hospitalize most of the patients.