• Andrea Mortara, Domenico Gabrielli, Francesco Rocco Pugliese, Antonio Corcione, Francesco Perticone, Andrea Fontanella, Giuseppe Mercuro, Claudio Cricelli, Massimo Iacoviello, Gaetano D'Ambrosio, Fabio Guarracino, Pietro Amedeo Modesti, Giorgio Vescovo, Renata De Maria, Attilio Iacovoni, Francesca Macera, Vittorio Palmieri, Daniele Pasqualucci, Ilaria Battistoni, Gianfranco Alunni, Nadia Aspromonte, Pasquale Caldarola, Mauro Campanini, Roberto Caporale, Giancarlo Casolo, Manlio Cipriani, Giuseppe Di Tano, Stefano Domenicucci, Adriano Murrone, Federico Nardi, Alessandro Navazio, Fabrizio Oliva, Damiano Parretti, Stefano Urbinati, Serafina Valente, Valentina Valeriano, Guerrino Zuin, Marco Metra, Gianfranco Sinagra, Michele Massimo Gulizia, and Andrea Di Lenarda.
• Dipartimento di Cardiologia Clinica, Policlinico di Monza, Monza (MB).
• G Ital Cardiol (Rome). 2019 May 1; 20 (5): 289-334.

AbstractAcute heart failure (AHF) represents a relevant burden for emergency departments worldwide. AHF patients have markedly worse long-term outcomes than patients with other acute cardiac diseases (e.g. acute coronary syndromes); mortality or readmissions rates at 3 months approximate 33%, whereas 1-year mortality from index discharge ranges from 25% to 50%.The multiplicity of healthcare professionals acting across the care pathway of AHF patients represents a critical factor, which generates the need for integrating the different expertise and competence of general practitioners, emergency physicians, cardiologists, internists, and intensive care physicians to focus on care goals able to improve clinical outcomes.This consensus document results from the cooperation of the scientific societies representing the different healthcare professionals involved in the care of AHF patients and describes shared strategies and pathways aimed at ensuring both high quality care and better outcomes. The document describes the patient journey from symptom onset to the clinical suspicion of AHF and home management or referral to emergency care and transportation to the hospital, through the clinical diagnostic pathway in the emergency department, acute treatment, risk stratification and discharge from the emergency department to ordinary wards or home. The document analyzes the potential role of a cardiology fast-track and Observation Units and the transition to outpatient care by general practitioners and specialist heart failure clinics.The increasing care burden and complex problems generated by AHF are unlikely to be solved without an integrated multidisciplinary approach. Efficient networking among emergency departments, intensive care units, ordinary wards and primary care settings is crucial to achieve better outcomes. Thanks to the joint effort of qualified scientific societies, this document aims to achieve this goal through an integrated, shared and applicable pathway that will contribute to a homogeneous care management of AHF patients across the country.

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