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Management of acute left ventricular failure

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

  • intravenous opiate analgesia:
    • 5 mg diamorphine over 5 min

  • treatment of arrhythmias:
    • may require DC cardioversion or intravenous anti- arrhythmic therapy

  • vasodilator therapy

  • digoxin:
    • cautious intravenous administration if the above fail

  • venesection:
    • 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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