Clinical Presentation and Precipitating Factors for Acute Heart Failure Hospitalization

Introduction: Acute heart failure syndromes are the most common cause of hospitalization in patients over 65 year. The number of hospitalizations for heart failure has tripled over the last three decades and it is expected to grow further.
Matherials and methods: We followed 390 patients, with an average age of 69.2 yrs, admitted in the Cardiology Department of Internal Medicine Clinic IV of Târgu Mureș, from January 2009 till January 2010 for treatment of the acute heart failure. The aim of this study was the analization of the clinical presentation and the precipitating factors of the heart failure at these patients.
Results and discussions: The most common clinical presentation at this category of patients is decompensated heart failure (peripherial oedema/congestion). In this particular case over two thirds of patients have history of heart failure (p < 0.0001). Hypertensive heart failure is a common finding in the novo cases (p = 0.0004). Cardiogenic shock is relatively rare form at this group but with very high hospital mortality. The most common trigger is infection, that frequently causes acute heart failure syndromes, mostly right heart failure in patients with pulmonary cardiopathy (p < 0.003). It is the most frequently identified trigger, both, in worsening chronic heart failure (p = 0.0002) and de novo heart failure group (p = 0.251).
Conclusions: The prevalence of triggers varies considerably depending on the target population, but infections, arrhythmias, elevated blood pressure and non-compliance remain frequent causes of acute heart failure syndromes.