Profile of the acute heart failure patient in Portugal

This editorial refers to ‘‘Characterization of acute heart failure hospitalizations in a Portuguese cardiology department’’ by A.C. Pinho-Gomes et al. Acute heart failure (AHF) is a highly prevalent condition, a common cause of hospitalization associated with significant in-hospital mortality and poor shortand longer-term outcomes, and represents a significant burden on overall healthcare costs. The condition is difficult to define and classify. The latest ESC guidelines on acute and chronic heart failure (HF) refer to AHF as ‘‘the term used to describe the rapid onset of, or change in, symptoms and signs of heart failure. It is a life-threatening condition that requires immediate medical attention and usually leads to urgent admission to hospital.’’ The assumptions included in this apparently undefined ‘‘definition’’ of AHF in fact apply to all forms of acute heart failure, a complex clinical syndrome that varies widely in terms of underlying pathophysiologic mechanisms, clinical presentations and targeted therapies. Most AHF patients presenting to an emergency department are admitted to hospital and it is the most common diagnosis at discharge in patients aged >65 years. The syndrome’s high in-hospital mortality of 3-12% and short-term readmission rate of 25-30%, with the associated costs, are critical issues worldwide.