Severe Heart Failure Management
Severe Heart Failure Management
Severe Heart Failure Management
Right ventricular infarction. Suspect in all patients with inferior STEMI
Preload = initial myocardial fibre length prior to contraction; determined by anything that effects ventricular volume at the end of diastole
Pericarditis = inflammation in the pericardium
Features that distinguish Pulmonary Embolus from Right Ventricular Infarction
Pericardial disease
Syncope is transient, self-limited loss of consciousness with an inability to maintain postural tone that is followed by spontaneous recovery. Such an event without loss of consciousness is often termed “presyncope”. Underlying cause is often not found in the emergency department (~50%)
pCO2 gap is a surrogate for cardiac output; pCO2 gap = PcvCO2 - PaCO2; pCO2 gap >6 mmHg suggests a persistent shock state that may be amenable to fluid resuscitation +/- intrope support; a “ScvO2-cvaCO2gap-guided protocol” has been proposed to guide the management of septic shock
Lung volume reduction surgery is performed on a high risk population with an associated mortality of 5-10%. The goal of the operation is to eliminate the most diseased areas of lung to reduce overall lung volume and improve respiratory mechanics
Chylothorax occurs when chyle from the thoracic duct empties into the pleural space. Chyle is a milky white fluid with a high concentration of triglycerides, chylomicrons, and white blood cells. Pseudochylothorax is pleural fluid that mimics true chylous pleural effusion in appearance but lacks the biochemical criteria for chylothorax; usually due to a longstanding pleural effusion
Vasoplegia Post Cardiopulmonary Bypass. Common; results from a bypass-induced SIRS response, but other causes of vasodilation (e.g. drugs, sepsis) can also contribute
Post-Pericardotomy Syndrome = febrile illness secondary to an inflammatory reaction involving the pleura + pericardium.