Management of acute left ventricular failure
The principles of treating acute heart failure are presented below:
- lung function optimisation:
- sit the patient up
- administer maximal oxygen concentrations
- intravenous diuretic:
- 40-80 mg frusemide
- 40-80 mg frusemide
- intravenous opiate analgesia:
- 5 mg diamorphine over 5 min
- 5 mg diamorphine over 5 min
- treatment of arrhythmias:
- may require DC cardioversion or intravenous anti- arrhythmic therapy
- may require DC cardioversion or intravenous anti- arrhythmic therapy
- vasodilator therapy
- digoxin:
- cautious intravenous administration if the above fail
- cautious intravenous administration if the above fail
- venesection:
- a pint may be removed from a moribund patient who fails to respond to the above
- a pint may be removed from a moribund patient who fails to respond to the above
- inotropes:
- dobutamine infusion
- dopamine infusion
Topics specific to the treatment of acute right ventricular failure are discussed elsewhere.
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