ISSN 1671-5411 CN 11-5329/R
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Volume 18 Issue 7
Jul.  2021
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Article Navigation >  Journal of Geriatric Cardiology  > 2021  >  18(7): 560-576
Please cite this article as: Tersalvi G, Gasperetti A, Schiavone M, Dauw J, Gobbi C, Denora M, Krul JD, Cioffi GM, Mitacchione G, Forleo GB. Acute heart failure in elderly patients: a review of invasive and non-invasive management. J Geriatr Cardiol 2021; 18(7): 560−576. DOI: 10.11909/j.issn.1671-5411.2021.07.004
Citation: Please cite this article as: Tersalvi G, Gasperetti A, Schiavone M, Dauw J, Gobbi C, Denora M, Krul JD, Cioffi GM, Mitacchione G, Forleo GB. Acute heart failure in elderly patients: a review of invasive and non-invasive management. J Geriatr Cardiol 2021; 18(7): 560−576. DOI: 10.11909/j.issn.1671-5411.2021.07.004
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Acute heart failure in elderly patients: a review of invasive and non-invasive management

doi: 10.11909/j.issn.1671-5411.2021.07.004
  • 1.

    Department of Internal Medicine, Hirslanden Klinik St. Anna, Lucerne, Switzerland

  • 2.

    Cardiology Unit, ASST-Fatebenefratelli Sacco, Luigi Sacco University Hospital, Milan, Italy

  • 3.

    Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium

  • 4.

    Doctoral School for Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium

  • 5.

    Institut Cardiovasculaire de Caen, Hôpital Privé Saint Martin, Caen, France

  • 6.

    Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland

  • 7.

    Division of Cardiology, Heart Center, Luzerner Kantonsspital, Lucerne, Switzerland

*The authors contributed equally to this manuscript
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    Abstract
  • Acute heart failure (AHF) is a major cause of unplanned hospitalisations in the elderly and is associated with high mortality. Its prevalence has grown in the last years due to population aging and longer life expectancy of chronic heart failure patients. Although international societies have provided guidelines for the management of AHF in the general population, scientific evidence for geriatric patients is often lacking, as these are underrepresented in clinical trials. Elderly have a different risk profile with more comorbidities, disability, and frailty, leading to increased morbidity, longer recovery time, higher readmission rates, and higher mortality. Furthermore, therapeutic options are often limited, due to unfeasibility of invasive strategies, mechanical circulatory support and cardiac transplantation. Thus, the in-hospital management of AHF should be tailored to each patient’s clinical situation, cardiopulmonary condition and geriatric assessment. Palliative care should be considered in some cases, in order to avoid unnecessary diagnostics and/or treatments. After discharge, a strict follow-up through outpatient clinic or telemedicine is can improve quality of life and reduce rehospitalisation rates. The aim of this review is to offer an insight on current literature and provide a clinically oriented, patient-tailored approach regarding assessment, treatment and follow-up of elderly patients admitted for AHF.
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