Acute Heart Failure is a condition that predominantly affects male patients older than 70 years of age. These patients typically present with a pre-existing cardiac condition such as ischemic heart disease and congestive heart failure. A majority of these patients will actually have a history of a previous heart failure, and will present with decompensation of their existing disease.

In short, elderly men with known heart conditions tend to develop acute heart failure and it is usually a worsening of their pre-existing condition rather than a sudden onset of acute heart failure with no prior heart disease or risk factors.

It should be noted that AHF is not limited to patients with pre-existing heart conditions, there are also cases where patients may develop sudden signs and symptoms of heart failure as well (de novo acute heart failure).

What exactly is Acute Heart Failure?

Acute heart failure is a clinical syndrome with characteristic signs and symptoms that come about due to the failure of the heart’s function of pumping blood throughout a person’s body. The term “acute” refers to the rapid development of new or worsening of pre-existing signs and symptoms of heart failure.

What’s the Difference Between Acute and Chronic Heart Failure?

The condition of patients who develop heart failure don’t typically return back to the baseline prior to the heart failure. This is because the damage that is done to the heart is usually permanent.

Heart failure is considered “chronic” if a patient has been suffering from heart failure for an extended period of time, additionally, if the patient is treated and their condition does not deteriorate for at least a month, they are considered “stable.”

Heart failure is considered acute if the onset of symptoms occur suddenly, such as in the case of acute myocardial infarction (AMI), where the coronary arteries which supply blood to the heart can be affected, causing ischemic injury to the heart.

What Causes Heart Failure?

This condition comes about when there are anatomical (structural) and/ or functional abnormalities within the heart, causing:

1. A decrease in the amount of blood the heart is able to pump out per beat. This causes the patient’s systemic symptoms such as lower limb swelling, difficulty of breathing, and tiredness.
2. Places stress on the heart as it tries to compensate (increased cardiac pressures).m As the heart continues to compensate, the cells of the heart may experience ischemic injury, causing the chest pain.

What are Signs and Symptoms of Acute Heart Failures?

AHF typically present with the following signs and symptoms:

• Chest pain or discomfort that may radiate to one or both arms, the neck, jaw, back, and stomach.This pain can be described as pressure, tightness, or fullness
• Dyspnea (shortness of breath/ difficulty breathing)
• Easy fatigability
• Dizziness or lightheadedness
• Nausea
• Diaphoresis (sweating)

When Should You Seek Help?

Experiencing the symptoms mentioned above, especially chest pain and difficulty breathing, should prompt patients to seek medical attention. But these are not the only findings of heart failure, as the condition may present subtly.

Patients should seek medical attention if they experience any of the following:

• An unexplained change in weight by at least 4 pounds
• Increased lower limb swelling
• Worsening of dyspnea
• Respiratory infections that worsen in severity
• A worsening cough, especially at night
• Changes in sleeping pattern (difficulty sleeping)
• A decrease in the amount of urine produced
• Dark color of the urine
• Easy fatigability
• Unusually tired/sleepy
• Restlessness or confusion
• Nausea and vomiting
• Poor appetite
• Chest pain or discomfort during activities, but relieved at rest
• A fast heart rate greater than or equal to 120 beats per minute while at rest

Certain symptoms can be more foretelling of the severity of a patient’s condition than others. If a patient experiences any of the symptoms listed below, they should seek emergency medical care as soon as possible:

• New onset of severe burning chest pain that is accompanied by dyspnea, sweating, weakness, and/ or nausea. This chest pain may be described as burning, lasts longer than 15 minutes and is not relieved by resting or taking nitroglycerin.
• Tachycardia or fast heart beat (at around 120-150 bpm) even while at rest.
• Difficulty breathing that doesn’t go away after resting
• Inability to move arms and/ or legs, if not weakness
• A headache that is severe and occurs suddenly
• An alteration in your level of consciousness

Key Takeaways

Acute heart failure is a serious condition that typically presents as sudden chest pain or difficulty breathing associated with easy fatigability, nausea, and sweating. It is caused by deteriorating heart function due to ischemic injury, structural abnormality, or dysfunction of the heart.

If you experience some or all of the symptoms mentioned above, consult your doctor as soon as possible.