Chronic heart failure

December 2010

FocusChronic heart failure

Acute pulmonary oedema

Management in general practice

Volume 39, No.12, December 2010 Pages 910-914

Andrew Baird


Acute pulmonary oedema is a life threatening emergency that requires immediate intervention with a management plan and an evidence based treatment protocol.


This article describes the features, causes, prevalence and prognosis of heart failure and the management of acute pulmonary oedema.


Presentations of acute pulmonary oedema and acute heart failure to general practice require a coordinated and urgent response. Initial assessment, management and monitoring should occur concurrently and must be modified in response to clinical changes.

Acute heart failure (AHF) is a clinical syndrome characterised by the rapid onset and progression of breathlessness and exhaustion. There is usually fluid overload.1 Acute heart failure typically occurs as ‘acute decompensated heart failure’ (ADHF) either secondary to chronic heart failure (CHF) or de novo. The more severe presentations of acute heart failure are acute pulmonary oedema (APO) and cardiogenic shock. In the EuroHeart Failure Survey II2 of patients hospitalised with AHF, 37% had de novo acute heart failure and 16% had APO.

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