MANAGEMENT OF PROFILE B ACUTE DECOMPENSATED HEART FAILURE IN THE EMERGENCY DEPARTMENT

Abstract

Acute decompensated heart failure (ADHF) is one of the leading causes of emergency department visits worldwide and is associated with high rates of morbidity, mortality, and hospital readmission. Among the hemodynamic profiles described in acute heart failure, Profile B (“warm and wet”) is the most common clinical presentation, characterized by pulmonary and/or systemic congestion associated with preserved tissue perfusion. Given the clinical relevance of this condition, this study aimed to analyze the scientific evidence regarding the management of Profile B acute decompensated heart failure in emergency settings. This study consists of an integrative literature review conducted through searches in the PubMed/MEDLINE, SciELO, ScienceDirect, Virtual Health Library (VHL), and Scopus databases. Scientific articles, clinical guidelines, and observational studies published over the last 10 years in English, Portuguese, and Spanish were included, addressing the diagnosis, risk stratification, and treatment of Profile B acute decompensated heart failure. The findings demonstrated that the early recognition of congestion through the integration of clinical assessment, cardiac biomarkers, and lung ultrasound significantly improves diagnostic accuracy and therapeutic decision-making. Regarding treatment, there was a consensus on the use of intravenous loop diuretics as first-line therapy, complemented, when indicated, by intravenous vasodilators and noninvasive ventilatory support. Risk stratification was also identified as a key component in determining patient disposition and optimizing clinical management. It is concluded that effective management of Profile B acute decompensated heart failure depends on the prompt identification of congestion and the rapid implementation of evidence-based therapeutic strategies, contributing to improved clinical outcomes and reduced healthcare burden.