Table 1: Clinical Syndromes in Acute Heart Failure.

Acute Heart Failure Syndrome	Description	Incidence (%)
Worsening chronic heart failure	Progressive systemic ± pulmonary congestion typically over days to weeks BP may be normal, mildly elevated or low	60–70
Hypertensive heart failure	Predominantly pulmonary congestion Systemic congestion less common More likely to have preserved ejection fraction	25–50
Acute coronary syndrome and heart failure	Clinical, electrocardiographic and biochemical features of ischaemia alongside heart failure Heart failure may completely resolve on resolution of the ischaemia (i.e. following PCI/thrombolysis)	30–40
Cardiogenic pulmonary oedema	Classic ‘acute heart failure’ Severe dyspnoea, tachycardia, tachypnoea Hypoxaemia may require intubation and ventilation Subset – ‘flash’ pulmonary oedema characterised by particularly rapid onset, often in association with severe systemic hypertension	25–40
Low BP (< 90 mmHg)	Indicative of low cardiac output, usually associated with renal dysfunction. High mortality	<8
Cardiogenic shock	Inadequate end-organ perfusion, haemodynamic instability ± malignant arrhythmia Poorest outcome, typically associated with ischaemia or fulminant myocarditis	1–3
Isolated right heart failure	e.g. cor pulmonale, right ventricular infarct Low cardiac output state, reduced LV fillingPredominant systemic congestion, hepatomegaly	5

Incidence figures refer to patients presenting to hospital with features of acute heart failure. BP = blood pressure; LV = left ventricle; PCI = percutaneous coronary intervention. Adapted from Gheorghiade et al.[16]