Malnutrition is prevalent among inpatients with acute cardiovascular conditions, with estimates ranging from 20% to 60% in hospitalized populations. Although most literature emphasizes heart failure, malnutrition also affects patients with acute coronary syndromes, arrhythmias, and valvular disease.
Application of Global Leadership Initiative on Malnutrition criteria to cardiovascular patients has demonstrated prognostic relevance, linking malnutrition to reduced physical function and higher mortality risk. Nutritional management should be initiated early in the inpatient setting, especially within the cardiac intensive care unit.
Enteral feeding within 48 hours of admission is preferred and is favored for cost-effectiveness relative to parenteral nutrition. Enteral nutrition has the potential to reduce mortality and shorten hospital stays when feasible.
Parenteral nutrition is reserved for cases of severe gastrointestinal dysfunction or when enteral feeding is contraindicated or insufficient, such as during high vasopressor doses that impair intestinal perfusion or when nutritional targets remain unmet after the first week. Regarding protein targets in cardiogenic shock, evidence is evolving; higher protein strategies have not shown consistent benefit in recent critical care trials, indicating ongoing uncertainty in this subgroup.