Background: Acute heart failure (AHF) exacerbations are a leading cause of hospitalization in the United States. Despite the frequency of AHF hospitalizations, there are inadequate data or practice guidelines on how quickly diuresis should be achieved. Methods: We conducted a pooled cohort study using data from three acute heart failure trials (DOSE, ROSE, and ATHENA-HF). [...]

Background: Acute heart failure (AHF) exacerbations are a leading cause of hospitalization in the United States. Despite the frequency of AHF hospitalizations, there are inadequate data or practice guidelines on how quickly diuresis should be achieved. Methods: We conducted a pooled cohort study using data from three acute heart failure trials (DOSE, ROSE, and ATHENA-HF). [...]

Background: Diuretic therapy is the mainstay of treatment for heart failure exacerbations but its optimal dosing strategy remains unclear. In 2011, the DOSE trial exhibited a trend toward improvement in patients’ global symptom assessments when utilizing a high-dose diuretic strategy, which used nearly 80mg intravenous furosemide three times daily in the first 72 hours on [...]

Background: Acute decompensated heart failure exacerbation is the leading cause of hospitalization in the United States. It was associated with total medical costs of more than $30 billion in 2012 with projections estimating around $70 billion in costs by 2030. Currently, six million people in the U.S. have heart failure, with a little over half [...]

Background: Heart failure (HF) is a common, chronic clinical syndrome often accompanied by episodes of acute decompensation driven by volume overload (1). Reversing this overloaded state is the principal goal in treatment of acute decompensated HF, typically achieved using loop diuretics (2). Despite ubiquitous use of loop diuretics, guidance on initial dosing strategies remains limited [...]

Case Presentation: The case begins with a 71-year-old female named MB. She initially presented with two weeks of worsening back pain, falls, and renal insufficiency. The pain itself radiated from her mid epigastrium to her back. The patient had a past medical history of COPD, paroxysmal atrial fibrillation, and heart failure with reduced ejection fraction. [...]

Background: Acute heart failure exacerbations remain a leading cause of morbidity and mortality and are associated with high rates of hospital admissions and healthcare expenditure. As hospital medicine (HM) primary service footprint expands, further information regarding patient care provided by HM compared to cardiology (CV) is needed. As part of a broader effort to improve [...]

Background: Acute decompensated heart failure exacerbations remain a leading cause of morbidity and mortality and are associated with high rates of admissions and healthcare cost. Both the initial dose of intravenous (IV) diuretic and time to administration affect inpatient outcomes. Adequate diuresis prior to discharge is associated with a reduced likelihood of readmission. As part [...]

Case Presentation: A 62-year-old man with a history of diabetes presented to the emergency department with altered mental status (AMS) and increased urinary frequency. The patient was conscious but oriented only to self. Initial evaluation revealed hyponatremia (serum sodium: 125 mmol/L) with mild hyperglycemia (186 mg/dL). Further assessment of hyponatremia showed a serum osmolality of [...]