Abstract
Heart failure is a complex clinical syndrome resulting from structural and/or functional cardiac abnormalities that lead to elevated intracardiac filling pressures and/or reduced cardiac output at rest or during exertion. This guideline provides updated recommendations for the diagnosis, classification, and management of acute and chronic heart failure based on current evidence. Diagnosis integrates clinical assessment with natriuretic peptide testing, electrocardiography, echocardiography, and additional investigations to identify the underlying etiology and stratify risk. Management of chronic heart failure emphasizes four foundational pharmacological therapies, including renin–angiotensin system inhibitors (ACE inhibitors, ARBs, or ARNIs), beta-blockers, mineralocorticoid receptor antagonists, and sodium–glucose cotransporter-2 inhibitors, together with diuretics and adjunctive therapies when indicated. Device-based therapies, including cardiac resynchronization therapy, implantable cardioverter-defibrillators, mechanical circulatory support, and heart transplantation, are recommended for selected patients. In acute heart failure, treatment focuses on hemodynamic stabilization, relief of congestion, restoration of organ perfusion, identification of precipitating factors, and optimization of guideline-directed medical therapy before hospital discharge to reduce rehospitalization and mortality. These recommendations provide a standardized approach to improve the quality of heart failure management and patient outcomes.
