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Although several topics are more extensively covered than in previous versions, including some specific therapies, monitoring and disposition in the hospital, and the management of cardiogenic shock, the lack of high-quality evidence in acute, emergency, and critical care scenarios, poses a challenge for providing evidence-based recommendations, in particular when by comparison the data for chronic heart failure is so extensive. The paucity of evidence and specific recommendations for the general approach and management of acute heart failure in the emergency department is particularly relevant, because this is the setting where most acute heart failure patients are initially diagnosed and stabilized. The clinical phenotypes proposed are comprehensive, clinically relevant and with minimal overlap, whilst providing additional opportunity for discussion around respiratory failure and hypoperfusion.<\/jats:p>","DOI":"10.1093\/ehjacc\/zuab122","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T15:17:52Z","timestamp":1639408672000},"page":"173-185","source":"Crossref","is-referenced-by-count":42,"title":["Acute Heart Failure in the 2021 ESC Heart Failure Guidelines: a scientific statement from the Association for Acute CardioVascular Care (ACVC)\u00a0of the European Society of Cardiology"],"prefix":"10.1093","volume":"11","author":[{"given":"Josep","family":"Masip","sequence":"first","affiliation":[{"name":"Research Direction, Consorci Sanitari Integral, University of Barcelona , Jacint Verdaguer 90, ES-08970 Sant Joan Desp\u00ed, Barcelona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Frank 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Foundation Trust , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9ctor","family":"Bueno","sequence":"additional","affiliation":[{"name":"Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid,","place":["Spain"]},{"name":"Cardiology Department, Hospital Universitario 12 de Octubre, and Instituto de Investigaci\u00f3n Sanitaria Hospital 12 de Octubre (imas12) , Madrid,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Enfermedades Cardiovaculares (CIBERCV) , Madrid,","place":["Spain"]},{"name":"Facultad de Medicina, Universidad Complutense de Madrid , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Di Somma","sequence":"additional","affiliation":[{"name":"Department of Medical \u2013 Surgery Science and Translational Medicine, University of Rome Sapienza, \u00a0Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mucio","family":"Tavares","sequence":"additional","affiliation":[{"name":"Emergency Department, Heart Institute (InCor), University of S\u00e3o Paulo Medical School ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin R","family":"Cowie","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Guy\u2019s & St Thomas\u2019 NHS Foundation Trust & Faculty of Lifesciences & Medicine, King\u2019s College London , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Maisel","sequence":"additional","affiliation":[{"name":"University of California , San Diego, VA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d2sar","family":"Mir\u00f3","sequence":"additional","affiliation":[{"name":"Emergency Department, Hospital Cl\u00ednic, \u201cProcesses and Pathologies, Emergencies Research Group\u201d IDIBAPS, University of Barcelona , Barcelona, Catalonia,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Acute Heart Failure Study Group of the Association for Acute Cardiovascular Care (ACVC) of the European Society of Cardiology","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"key":"2026080909214469400_zuab122-B1","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart 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