Acute Emergency Department Management of Heart Failure

The Emergency Department (ED) is a common location for acutely decompensated Heart Failure (HF) patients to seek care. Consequently, there is the opportunity for significant clinical benefits when care is managed appropriately. This article reviews the importance of an accurate diagnosis, the necessity to search for underlying precipitants of the HF decompensation, and the impact of early treatment on the subsequent length of hospitalization. It also discusses the value of the ED observation unit for short intensive management of HF, the potential financial benefits of this strategy, and the ability of nesiritide to decrease future revisits when used in this environment.