Key points

 AHF refers to the rapid onset or worsening of signs and symptoms of heart failure and has a
high mortality rate.

 AHF can occur as new onset or as decompensation of CHF.

 Myocardial infarction is the leading cause of AHF.

 Patients may have signs and symptoms of pulmonary oedema, peripheral oedema, and
hypoperfusion.

 Early senior involvement is key for these complex patients.

 The ECG and chest X-ray are rarely normal.

 BNP is a sensitive but non-specific marker used to rule out heart failure.

 Treat hypoxia with oxygen.

 Actively look for underlying causative conditions and treat urgently.

 Medical management is mainly with diuretics, with some patients also receiving nitrates

 .