management of acute left ventricular failure

Last reviewed 08/2022

The principles of treating acute heart failure are presented below:

• lung function optimisation:
• sit the patient up
• administer maximal oxygen concentrations

• intravenous diuretic:
• 40-80 mg frusemide

• intravenous opiate analgesia:
• 5 mg diamorphine over 5 min

• treatment of arrhythmias:
• may require DC cardioversion or intravenous anti- arrhythmic therapy

• vasodilator therapy

• digoxin:
• cautious intravenous administration if the above fail

• venesection:
• a pint may be removed from a moribund patient who fails to respond to the above

• inotropes:
• dobutamine infusion
• dopamine infusion

Topics specific to the treatment of acute right ventricular failure are discussed elsewhere.