Residual congestion and clinical intuition in decompensated heart failure

J I Pérez Calvo; J Rubio Gracia; C Josa Laorden; J L Morales Rull

doi:10.1016/j.rce.2019.02.004

Residual congestion and clinical intuition in decompensated heart failure

Rev Clin Esp (Barc). 2019 Aug-Sep;219(6):327-331. doi: 10.1016/j.rce.2019.02.004. Epub 2019 Apr 17.

[Article in English, Spanish]

Authors

J I Pérez Calvo¹, J Rubio Gracia², C Josa Laorden², J L Morales Rull³

Affiliations

¹ Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España. Electronic address: jiperez@unizar.es.
² Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España.
³ Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, Lleida, España; Instituto de Investigación Biomédica Dr. Pifarré, Lleida, España.

PMID: 31005262
DOI: 10.1016/j.rce.2019.02.004

Abstract

Congestive symptoms are the key to recognising decompensated heart failure, whose treatment is based on reducing the congestion until a clinical situation has been reached that allows the patient to be discharged to continue outpatient treatment. The important aspect is not the degree of congestion at admission but rather the congestion that persists after energetic diuretic therapy. The persistence of congestive signs following an apparently correct and effective therapy has been called residual congestion and is associated with a poor prognosis. The tools for determining this condition are still rudimentary. Methods therefore need to be developed that enable a more accurate assessment.

Keywords: Congestion; Congestión; Congestión residual; Diuretic therapy; Heart failure; Insuficiencia cardiaca; Residual congestion; Terapia diurética.