| Summary: | Acute Heart Failure (AHF) is an increasingly common condition with a poor
prognosis. In contrast to CHF where advances in medical therapy and devices has
led to significant improvement in morbidity and mortality, the prognosis for AHF
has not changed significantly in the last few decades despite efforts to find
effective treatment. There are multiple factors that contribute to the high
mortality and morbidity of AHF; it can be a diagnostic challenge, determining
whether decongestion has been achieved can be difficult, and persisting
congestion is commonly present at discharge contributing to early decompensation
and rehospitalisation. Transthoracic echocardiogram (TTE) is a unique imaging
modality that is non-invasive, can be done at the bedside, in real time during
procedures, is affordable and easy to access both in community and inpatient
settings. Small hand held ‘point of care’ scans are increasingly available and
being used as an adjunct to improve clinical examination. Consequently, the use
of echocardiography to improve outcomes for patients with cardiac disease
continues to evolve. In chronic heart failure TTE has established roles in the
quantification of HF phenotype, and determination of treatment initiation,
escalation and success. However, the role of echocardiogram in AHF is not as well
established with society guidelines relying on expert consensus for their
recommendations. Use of TTE at all stages of AHF has potential to reduce
morbidity and mortality. This review discusses the evidence for use of TTE to
improve the diagnosis, prognosis and management of AHF.
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