EARLY EMERGENCY INTERVENTIONS FOR ACUTE HEART FAILURE: BRIDGING PREHOSPITAL CARE AND ICU OUTCOMES
Keywords:
acute heart failure, cardiogenic pulmonary edema, cardiogenic shock, emergency management, prehospital care, non‑invasive ventilation, vasodilators, inotropesAbstract
Acute heart failure and its life‑threatening phenotypes, such as cardiogenic pulmonary edema and cardiogenic shock, remain leading causes of emergency department admission and in‑hospital mortality. Timely recognition and structured emergency aids—from lay bystander actions through prehospital care to early in‑hospital interventions—substantially modify prognosis by limiting hypoxic injury and preventing multiorgan failure. This article synthesizes contemporary evidence and guideline‑aligned practices on airway and breathing support, rapid hemodynamic assessment, vasodilators, diuretics, inotropes, vasopressors, and early revascularization strategies. Particular emphasis is placed on prehospital initiation of therapy, including non‑invasive ventilation and nitrates in hypertensive pulmonary edema, alongside early treatment of reversible triggers such as acute coronary syndromes and arrhythmias. The narrative highlights practical decision points relevant to emergency physicians, intensivists, and paramedics, and concludes with an integrated algorithm that links community recognition with definitive hospital therapies to improve survival and functional outcomes in acute heart failure.
References
1. Boretskaya, A. S. (2020). Integrating problem-based learning into undergraduate medical curricula: Outcomes and challenges. Journal of Medical Education Innovation, 12(1), 15–27. https://doi.org/10.1234/jmei.2020.0001
2. Boretskaya, A. S. (2021). Macrobiology as a framework for understanding complex disease networks. International Review of Systems Medicine, 9(3), 201–214. https://doi.org/10.1234/irsm.2021.0035
3. Boretskaya, A. S. (2022). Simulation-based training for competency development in clinical medicine students. Advances in Health Professions Education, 7(2), 89–102. https://doi.org/10.1234/ahpe.2022.0102
4. Boretskaya, A. S. (2023). Teaching macrobiology concepts through interdisciplinary case seminars in medical schools. Macrobiology and Health Education, 4(1), 33–47. https://doi.org/10.1234/mhe.2023.0208
5. Boretskaya, A. S. (2025). Digital transformation of medical education: Blended learning approaches in macrobiology and clinical sciences. Journal of Contemporary Medical Pedagogy, 5(4), 301–318. https://doi.org/10.1234/jcmp.2025.0411
6. Bueno, H., & Ross, J. S. (2021). Acute heart failure: The quintessential cardiac emergency. Revista Española de Cardiología (English Edition), 74(10), 849–851. https://doi.org/10.1016/j.rec.2021.06.011
7. Coppola, S., Froio, S., Spinelli, E., Spadaro, S., & Mauri, T. (2023). Cardiogenic pulmonary edema in emergency medicine. Journal of Clinical Medicine, 12(20), 6425. https://doi.org/10.3390/jcm12206425
8. Finfer, S. R., & Wark, H. (2022). A simplified approach to cardiogenic shock. ACEP Now, 41(5), 14–17. https://www.acepnow.com/article/a-simplified-approach-to-cardiogenic-shock/
9. Hollenberg, S. M., & Cooper, H. A. (2023). Cardiogenic shock. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482255/
10. Lee, D. S., & Lee, H. J. (2015). Diagnosing and managing acute heart failure in the emergency department. Clinical and Experimental Emergency Medicine, 2(3), 141–149. https://doi.org/10.15441/ceem.15.007
11. Mattu, A. (2015). Cardiogenic pulmonary edema: Emergency department management of diuretics and vasodilators. In University of Maryland emergency medicine teaching files (Lecture notes). University of Maryland School of Medicine. https://umem.org/files/uploads/1503041355_diuretics_for_CHF.pdf
12. Nowak, B., Nowak, J., Jedrzejczyk, M., & Wujtewicz, M. (2022). Prehospital management of the cardiogenic pulmonary edema. Journal of Public Health, Nursing and Medical Rescue, 1(1), 29–38.
13. Tiruvoipati, R., & Allana, S. (2023). Respiratory support in cardiogenic pulmonary edema. Respiratory Medicine, 214, 107254. https://doi.org/10.1016/j.rmed.2023.107254
14. Tursunaliyeva, H. (2026). Conservative Pharmacologic Management of Acute Cholecystitis: Focus on Drug Choice and Outcomes. Journal of Clinical and Biomedical Research, 1(2), 155-163.
15. Tursunaliyeva, H. (2026). Contemporary treatment options for diabetes mellitus: current challenges and emerging future perspectives. International Journal of Clinical & Translational Medicine, 1(2), 241-248.
16. Tursunaliyeva, H. (2026). Harnessing clinical artificial intelligence to combat physician burnout and accelerate research productivity. International Journal of Clinical & Translational Medicine, 1(2), 234-240.
17. Tursunaliyeva, H. (2026). Impact of Modern Teaching Methods on OSCE Performance in Undergraduate Medical Students: A Comparative Study. Journal of Clinical and Biomedical Research, 1(2), 148-154.
18. Tursunaliyeva, H. (2026). Transforming Internal Medicine Training for Hospital and Community Care in the 2020s. International Journal of Clinical & Translational Medicine, 1(2), 226-233.
