Congestion in acute heart failure syndromes: importance of early recognition and treatment.

The vast majority of acute heart failure syndrome (AHFS) hospitalizations are related to clinical congestion, rather than to a low cardiac output state. Patients develop hemodynamic congestion (high left ventricular filling pressure) several days to weeks before the onset of clinical symptoms and signs. Congestion is an important predictor of both mortality and morbidity in patients with AHFS. As a result, congestion is an essential evaluative and therapeutic target in AHFS patients. It is plausible that early identification of hemodynamic congestion, before the clinical manifestations are present, could reduce the need for hospital admission and readmission.