Therapeutic strategy of the management of acute cardiac failure

Acute cardiac failure should be approached clinically and paraclinically as an emergency and precipitation is not always what is required. Consequentl y, strict clinical and paraclinical strategy leads to decisive action to im prove the prognosis. The authors describe the principles of management of acute cardiac failure. The different stages which are carried out simultaneously in clinical prac tice are discussed : physiopathological basis, clinical and paraclinical in vestigations, symptomatic and aetiological treatment. The description and i ndications of circulatory assistance are considered. This constitutes a maj or therapeutic advance of the last decade and has changed the treatment of the most severe clinical forms of acute cardiac failure.