Heart failure

2019 ◽  
pp. 537-546
Keyword(s):  
Heart Failure ◽  
Cardiac Dysfunction ◽  
Models Of Care ◽  
Life Care ◽  
Common Criteria ◽  
Objective Evidence ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Definition Of ◽  
European Society Of Cardiology

This chapter covers the issues surrounding heart failure in patients with palliative needs, including definition of heart failure, Management of heart failure, end-of-life care, complex decision-making, and models of care. Chronic heart failure is a progressive, terminal syndrome and is the final common pathway of many cardiovascular diseases. There is difficulty in defining heart failure as there are many different criteria around the world used to define it. However, common criteria usually include history, physical examination, chest radiography, and echocardiography. The European Society of Cardiology defines heart failure as the presence of symptoms of heart failure at rest or during exercise, and objective evidence of cardiac dysfunction (usually on echocardiography).

scholarly journals Upside down solutions: palliative care and COVID-19

2020 ◽  
pp. bmjspcare-2020-002385 ◽  
Author(s):  
Daniel Knights ◽  
Felicity Knights ◽  
Iain Lawrie
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Well Being ◽  
Models Of Care ◽  
Resource Limited ◽  
Relief Of Suffering ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Effective Use

The current COVID-19 pandemic is unprecedented and requires innovation beyond existing approaches to contribute to global health and well-being. This is essential to support the care of people at the end of their lives or who are critically ill from COVID-19 or other life-limiting illnesses. Palliative care (PC) is centred on effective symptom control, promotion of quality of life, complex decision-making, and holistic care of physical, psychological, social and spiritual health. It is ideally placed to both provide and contribute to care for patients, families, communities and colleagues during the pandemic. Where recovery is uncertain, emphasis should be on care and relief of suffering, as well as survival. Where healthcare resources and facilities come under intense pressure, lessons can be learnt from models of care in other settings around the world. This article explores how the field can contribute by ensuring that PC principles and practices are woven into everyday healthcare practice. We explore alternative ways of providing care under such pressure and discuss three areas of learning from resource-limited settings: (1) integration of palliative medicine into everyday practice, (2) simplification of biomedical management plus multidisciplinary teamwork and (3) effective use of volunteers.

Complex Decision-Making in Heart Failure

2018 ◽  
Vol 33 (3) ◽  
pp. 225-231 ◽  
Author(s):  
Aimee V. Hamel ◽  
Joseph E. Gaugler ◽  
Carolyn M. Porta ◽  
Niloufar Niakosari Hadidi
Keyword(s):  
Heart Failure ◽  
Decision Making ◽  
Complex Decision Making ◽  
Complex Decision

Incidence and definition of takotsubo syndrome

ESC CardioMed ◽  
2018 ◽  
pp. 1278-1280
Author(s):  
Abhiram Prasad
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Diagnostic Criteria ◽  
Apical Ballooning ◽  
Stress Cardiomyopathy ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
Definition Of ◽  
European Society Of Cardiology

Takotsubo syndrome (TTS) is also commonly known as apical ballooning syndrome and stress cardiomyopathy. The incidence of TTS has consistently been estimated to be close to 2% of all patients presenting with an initial diagnosis of an acute coronary syndrome, and perhaps as high as about 5% of women. TTS is a diagnosis of exclusion and in the absence of a diagnostic test, there is the need for diagnostic criteria. The Mayo Clinic diagnostic criteria are the most widely cited. The Heart Failure Association of the European Society of Cardiology published the most recent criteria in 2015.

Epidemiology and general pathophysiological classification of heart failure

2020 ◽  
pp. 3390-3397
Author(s):  
Theresa A. McDonagh ◽  
Kaushik Guha
Keyword(s):  
Heart Failure ◽  
Cardiac Dysfunction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Clinical Syndrome ◽  
Normal Left Ventricular ◽  
Patients With Heart Failure ◽  
Definition Of

Heart failure is a clinical syndrome caused by cardiac dysfunction, most commonly left ventricular systolic dysfunction. Patients with heart failure symptoms or signs and normal or near normal left ventricular function are often classified as having heart failure with preserved ejection fraction (HF-PEF), but there is no clear and generally accepted definition of this condition. Estimates of incidence and prevalence are heavily influenced by definition. Prevalence rises significantly with age, with a median age of first presentation in the mid-seventies. Longitudinal data suggests that the incidence of heart failure has remained fairly stable over the last few decades, but prevalence is increasing as more people survive cardiovascular disease earlier in life.

Chronic heart failure

2018 ◽  
Author(s):  
Kazem Rahimi
Keyword(s):  
Heart Failure ◽  
Venous Pressure ◽  
Clinical Syndrome ◽  
Short Term ◽  
Functional Abnormality ◽  
Angiotensin System ◽  
Risk Of Death ◽  
Objective Evidence ◽  
European Society Of Cardiology ◽  
Necrosis Factor

The European Society of Cardiology defines heart failure as a clinical syndrome in which patients have the following features: symptoms typical of heart failure (breathlessness, fatigue, ankle swelling); signs typical of heart failure (tachycardia, tachypnoea, pulmonary crackles, pleural effusion, raised jugular venous pressure, peripheral oedema, hepatomegaly); and objective evidence of a structural or functional abnormality of the heart at rest (cardiomegaly, third heat sound, cardiac murmurs, abnormality on the echocardiogram, raised natriuretic peptide concentration). Heart failure results in activation of the sympathetic nervous system and the renin–aldosterone–angiotensin system, and release of a number of hormones such as natriuretic peptides, and cytokines, including tumour necrosis factor amongst others. While neurohormone activation is initially compensatory and helps in the short term to maintain circulatory needs, ultimately it has detrimental effects on the myocardium and compromises its function further. These mechanisms are therefore therapeutic targets to improve symptoms and lessen the risk of death.

scholarly journals The Michigan Appropriateness Guide for Intravenous Catheters in children with congenital heart disease: miniMAGIC-CHD

2021 ◽  
pp. 1-5
Author(s):  
Tanya Perry ◽  
Amanda J Ullman ◽  
Ranjit Aiyagari ◽  
Stephanie Pitts ◽  
Jeffrey P Jacobs ◽  
...  
Keyword(s):  
Evidence Based ◽  
Scenario Development ◽  
Case Scenario ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Selection For ◽  
Definition Of ◽  
Key Terms ◽  
Intravenous Catheters

Abstract Background: The approach to vascular access in children with CHD is a complex decision-making process that may have long-term implications. To date, evidence-based recommendations have not been established to inform this process. Methods: The RAND/UCLA Appropriateness Method was used to develop miniMAGIC, including sequential phases: definition of scope and key terms; information synthesis and literature review; expert multidisciplinary panel selection and engagement; case scenario development; and appropriateness ratings by expert panel via two rounds. Specific recommendations were made for children with CHD. Results: Recommendations were established for the appropriateness of the selection, characteristics, and insertion technique of intravenous catheters in children with CHD with both univentricular and biventricular physiology. Conclusion: miniMAGIC-CHD provides evidence-based criteria for intravenous catheter selection for children with CHD.

scholarly journals The Role of Genetics in Cardiomyopaties: A Review

2021 ◽  
Author(s):  
Luis Vernengo ◽  
Haluk Topaloglu
Keyword(s):  
Heart Failure ◽  
Sudden Death ◽  
European Society ◽  
Cardiac Dysfunction ◽  
American Heart Association ◽  
Heart Association ◽  
The Other ◽  
Systemic Disorder ◽  
European Society Of Cardiology

Cardiomyopathies are defined as disorders of the myocardium which are always associated with cardiac dysfunction and are aggravated by arrhythmias, heart failure and sudden death. There are different ways of classifying them. The American Heart Association has classified them in either primary or secondary cardiomyopathies depending on whether the heart is the only organ involved or whether they are due to a systemic disorder. On the other hand, the European Society of Cardiology has classified them according to the different morphological and functional phenotypes associated with their pathophysiology. In 2013 the MOGE(S) classification started to be published and clinicians have started to adopt it. The purpose of this review is to update it.

Incidence and definition of takotsubo syndrome

ESC CardioMed ◽  
2018 ◽  
pp. 1278-1280
Author(s):  
Abhiram Prasad
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Diagnostic Criteria ◽  
Apical Ballooning ◽  
Stress Cardiomyopathy ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
Definition Of ◽  
European Society Of Cardiology

Takotsubo syndrome (TTS) is also commonly known as apical ballooning syndrome and stress cardiomyopathy. The incidence of TTS has consistently been estimated to be close to 2% of all patients presenting with an initial diagnosis of an acute coronary syndrome, and perhaps as high as about 5% of women. TTS is a diagnosis of exclusion and in the absence of a diagnostic test, there is the need for diagnostic criteria. The Mayo Clinic diagnostic criteria are the most widely cited. The Heart Failure Association of the European Society of Cardiology published criteria in 2015. An update to this chapter includes the most recent criteria from 2018.

Abstract 14841: Definitions of Stage D Heart Failure and Survival: Comparing INTERMACS Profiles, ESC Criteria, and Physician Assessment

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jeffrey S Hedley ◽  
Ayman S Tahhan ◽  
Andrew A McCue ◽  
Jonathan B Bjork ◽  
Mariyah Yazdani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Transplant ◽  
Circulatory Support ◽  
Prognostic Information ◽  
Consensus Definition ◽  
Physician Assessment ◽  
Advanced Therapies ◽  
Definition Of ◽  
European Society Of Cardiology ◽  
Stage D

Introduction: Care for patients with stage D heart failure (HF) is becoming increasingly complex in the era of mechanical circulatory support (MCS). However, an operational consensus definition of stage D HF is currently lacking. Hypothesis: Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profiles better identify outpatients with stage D HF compared to European Society of Cardiology Heart Failure Association (ESC-HFA) criteria and physician assessment. Methods: We evaluated 474 outpatients with systolic HF (ejection fraction [EF] <40%) who received care in Q1 2012 and have not previously received advanced therapies (age, 61±15 years; 35.4% women; 44.7% white, 46.8% black; EF 24±10%; 67.2% with ischemic heart disease; 6.3% on home inotropes). We applied INTERMACS profiles (defining stage D as profiles 2-5) and ESC-HFA criteria to identify stage D HF, and compared with physician-derived stage D identification based on evaluations for advanced therapies (MCS, heart transplant, or palliative care). We then compared 3-year mortality across definitions. Results: INTERMACS profiles, ESC-HFA criteria, and physicians identified 50 (10.5%), 59 (12.4%), and 64 (13.5%) of 474 patients, respectively, as having stage D HF. Concordance between definitions was low, with κ =0.35 (optimal: 1.0). After a median of 3.1 years (1.6, 3.3), 95 patients died (3-year mortality: 21.4%). In addition, 24 patients received MCS and 11 received heart transplant. Mortality was 51.2%, 43.7%, and 34.5% for INTERMACS-, ESC-HFA-, and physician-identified stage D HF patients, respectively ( Figure 1 ). The INTERMACS definition provided the best prognostic separation between stage D and C HF patients, as measured by the Royston’s R 2 statistic ( Figure 1 ). Conclusions: INTERMACS profiles provide a reasonable alternative for the identification of stage D patients in ambulatory systolic HF populations and offer better prognostic information than the ESC-HFA criteria.

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