Acute decompensated heart failure: diagnosis and management.

ABSTRACT

Chronic heart failure is common in the UK, with a prevalence estimated at 3% of people aged between 65 and 74 years. This prevalence increases with age and affects approximately 15% of the older population (British Heart Foundation, 2011). A significant number of such people are diagnosed after presenting to their local emergency department with severe breathlessness. Advances in patient management have improved outcomes, but the prognosis remains poor. A recent epidemiological study of patients with heart failure in north west London reported that around 14% of patients die within 6 months of diagnosis (Mehta et al, 2009). The UK national audit data of 2011-2012 reported that approximately 11% of patients admitted to hospital with acute heart failure die during their in-hospital stay. For those discharged, there is a greater-than-25% risk of death within 12 months. This risk of in-hospital and 12-month mortality varies widely, but appears to largely relate to the inpatient management and organisation of follow-up (National Institute for Cardiovascular Outcomes Research, 2012).