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# Acute Decompensated Heart Failure ## Management 1. **IV Diuretics (IV Bolus)**: * 360 mg (Furosemide) 2. **Semi recumbent position (45°)** 3. **High flow O2 Via NRBM/NIV** 4. **Morphine:** * 4 mg IV. * For extravascular fluid shift. 5. **BP control** * Doc: NTG at 5 µg/min. ##...

# Acute Decompensated Heart Failure ## Management 1. **IV Diuretics (IV Bolus)**: * 360 mg (Furosemide) 2. **Semi recumbent position (45°)** 3. **High flow O2 Via NRBM/NIV** 4. **Morphine:** * 4 mg IV. * For extravascular fluid shift. 5. **BP control** * Doc: NTG at 5 µg/min. ## Cardiogenic Shock ### Features 1. Narrow pulse pressure (SBP < 90 mm of Hg). 2. Fatigue. 3. Altered mentation. 4. Cyanosis. 5. Cold extremities. *Note: Poor prognosis.* ## Management ### Investigations * Lactic acid levels: To r/o occult shock. * Rule out ACS → Do early ECHO → Rule out acute AR and acute MR. ### Treatment #### HFrEF 1. **Inotropic support / Inodilator** * Inotrope: Dobutamine (m/c). * Inodilator: milrinone (m/c). 2. **Intra-aortic balloon pump / ecmo support.** #### HFPEF * **Vasopressors**: vasopressin / Desmopressin. _Medicine v1.0. Marrow 8.0 2024_