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- Figure 1.
Clinical Phenotypes of Acute Heart Failure at Presentation
ACS=acute coronary syndrome; AH=arterial hypertension; EF=ejection fraction; HF=heart failure; HF-pEF=heart failure with preserved ejection fraction; JVD=jugular vein distension; LHF=left heart failure; MR=mitral regurgitation.
Reproduced with permission from S Kaouros, MD.
- Figure 2.
European Society of Cardiology Guidelines for Suspected Acute Heart Failure
*In the acute setting, MR-proANP may also be used (cut-off point 120 pmol/L, ie <120 pmol/L=HF unlikely); a Exclusion cut-off points for natriuretic peptides are chosen to minimize the false-negative rate while reducing unnecessary referrals for echocardiography; b Other causes of elevated natriuretic peptide levels in the acute setting are an acute coronary syndrome, atrial or ventricular arrhythmias, pulmonary embolism, and severe chronic obstructive pulmonary disease with elevated right heart pressures, renal failure, and sepsis. Other causes of an elevated natriuretic level in the non-acute setting are: old age (>75 years), atrial arrhythmias, left ventricular hypertrophy, chronic obstructive pulmonary disease, and chronic kidney disease; c Treatment may reduce natriuretic peptide concentration, and natriuretic peptide concentrations may not be markedly elevated in patients with HF-PEF.
BNP=B-type natriuretic peptide; ECG=electrocardiogram; ED=erectile dysfunction; HF=heart failure; MR-proANP=mid-regional pro atrial natriuretic peptide; NT-proBNP=N-terminal pro B-type natriuretic peptide.
Reproduced from McMurray JJ et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012;33(14):1787–1847. With permission from Oxford University Press.
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