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Hemodynamic effects of ivabradine use in combination with intravenous inotropic therapy in advanced heart failure
AbstractIntravenous inotropic therapy can be used in patients with advanced heart failure, as palliative therapy or as a bridge to cardiac transplantation or mechanical circulatory support, as well as in cardiogenic shock. Their use is limited to increasing cardiac output in low cardiac output states and reducing ventricular filling pressures to alleviate patient symptoms and improve functional class. Many advanced heart failure patients have sinus tachycardia as a compensatory mechanism to maintain cardiac output. However, excessive sinus tachycardia caused by intravenous inotropes can increase myocardial oxygen consumpti...
Source: Heart Failure Reviews - September 29, 2020 Category: Cardiology Source Type: research

13 The shock team approach: the rationale and evidence
Cardiogenic shock (CS) is defined as a state of ineffective cardiac output caused by a cardiac disorder that results in both clinical and biochemical manifestations of inadequate tissue perfusion.1 Among patients presenting with CS, there is a spectrum of disease whereby some patients can be stabilised with pharmacologic interventions alone, while others require escalation to mechanical circulatory support (MCS).2 As patients and treatment options both become increasingly complex, comprehensive critical care may be best delivered in disease-specific service line ICUs.2 The model of the cardiac ICU has transitioned over tim...
Source: Heart Asia - April 24, 2019 Category: Cardiology Authors: Kiernan, M. S. Tags: Keynote Lecture Source Type: research

Posterior Circulation Ischemia or Occlusion in Five Adults With Failing Fontan Circulation
Conclusions In adults with failing Fontan circulation there is a potential for neurologic complications as a result of venous congestion with elevated central venous pressures, and aberrant posterior circulation. The patient’s history and brain imaging may be used to identify at-risk patients and to tailor perioperative management during Fontan conversion or heart transplantation to mitigate the risk for brainstem ischemia.
Source: The Annals of Thoracic Surgery - May 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research