The current and future management of acute heart failure syndromes.

Hospitalization for heart failure (HF) marks a substantial crossroad for patients, as greater than one-third will be re-hospitalized or dead within 90 days post-discharge. For patients with chronic HF who present with acute heart failure syndromes (AHFS), they transition from an arena of well-established and life-saving evidence-based therapies to one where early pharmacological management has changed little over the last 40 years. Traditional therapies, such as oxygen, loop diuretics, nitrates, and morphine remain the cornerstone of early management today. Despite earlier initiation of chronic HF therapies during hospitalization, post-discharge event rates remain high. Optimizing management of known targets with proven evidence-based therapy has the potential to reduce post-discharge event rates. In this inaugural issue of the Frontiers in Cardiovascular Therapy, we briefly review current in-hospital management of AHFS, introduce the concept of cardiac reconstruction, and focus on the potential of future management strategies and therapeutics to improve outcomes in AHFS.