scholarly journals Value of Echocardiography in the Treatment of Patients With Acute Heart Failure

2021 ◽  
Vol 8 ◽  
Author(s):  
Masaki Izumo
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Cardiac Function ◽  
Acute Heart Failure ◽  
Optimal Treatment ◽  
Clinical Value ◽  
Mortality And Morbidity ◽  
Non Invasive ◽  
Life Threatening ◽  
Life Threatening Event

Heart failure (HF) is a burden in pandemic medicine resulting in high mortality and morbidity. Because acute HF is a life-threatening event, its diagnosis and choice of optimal treatment are important to improve outcomes. Furthermore, understanding the cause and hemodynamics of acute HF is important in selecting the optimal treatment for these patients. Echocardiography is widely used in daily clinical practice because of its non-invasive nature and excellent portability to understand cardiac function and hemodynamics. Echocardiography is highly recommended by guidelines in the practice of HF, but evidence is limited. In this review, I would like to share clinical value of echocardiography in the treatment of patients with acute HF and discuss the usefulness of echocardiography.

Life-threatening Takotsubo Cardiomyopathy

2011 ◽  
Vol 9 (2) ◽  
pp. 119 ◽  
Author(s):  
Karen Mrejen-Shakin ◽  
Ricardo Lopez ◽  
Mohandas M Shenoy ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Acute Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Stress Test ◽  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Assisted Ventilation ◽  
Two Dimensional ◽  
Life Threatening

Objective:To report a case of seizure-induced takotsubo cardiomyopathy with rare etiology and rarer complications.Methods:A 50-year-old woman had multiple epileptic seizures and later developed acute heart failure complicated by ventricular fibrillation and shock. A two-dimensional echocardiogram revealed apical ballooning of the left ventricle resembling a takotsubo (a Japanese fisherman's pot used to trap octopi). The apex was also hypokinetic.Results:The hemodynamic abnormalities normalized with defibrillation, assisted ventilation, inotropic support, and pressor agents. More importantly, the apical ballooning deformity and systolic dysfunction reversed. The echocardiogram normalized three months later. A nuclear treadmill stress test was negative for ischemia.Conclusions:Apical ballooning of the left ventricle and hypokinesis are typical echocardiographic features in takotsubo cardiomyopathy, a stress-induced heart disease. It may follow severe emotional, physical, and neurologic stressors, in our rare case, grand mal seizures (0.2 % of all takotsubo disease patients). Also rare are life-threatening complications. Based on these observations, in a case with severe stress followed by acute heart failure, takotsubo cardiomyopathy should be a major diagnostic consideration. The dramatic initial triggering event, in our case an epileptic seizure, should not mask the possibility of coexisting takotsubo cardiomyopathy. Awareness of this disease, anticipation of complications, and two-dimensional echocardiography will help channel the management in the right direction.

scholarly journals Multimodality imaging can shift the clinical approach and prognosis of a patient: from heart failure and angina to cardiac amyloidosis

2021 ◽  
Vol 31 (1) ◽  
pp. 103-110
Author(s):  
Alexandra Maria Chitroceanu ◽  
Alina Ioana Nicula ◽  
Roxana Cristina Rimbas ◽  
Mihaela Andreescu ◽  
Cristina Popp ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Amyloidosis ◽  
Multimodality Imaging ◽  
Clinical Status ◽  
Decompensated Heart Failure ◽  
Response To Therapy ◽  
Al Amyloidosis ◽  
Clinical Approach ◽  
Non Invasive ◽  
Life Threatening

AL (light chain) amyloidosis is a life threatening disease. Untreated patients with involvement of the heart, a condition known as cardiac amyloidosis (CA), tend to have the most rapid disease progression and worst prognosis. Therefore, it is essential to early recognize the signs of symptoms of CA, and to identify the affected individuals with readily available non-invasive tests, as timely therapy can prolong life. Different imaging tests are used to diagnose and stratify the risk of the disease noninvasively, and to follow-up of the disease course and response to therapy. In this light, we present a case of a woman with cardiovascular risk factors, initially admitted for typical angina and decompensated heart failure (HF), who was later diagnosed with AL amyloidosis with cardiac involvement, by using multimodality imaging assessment in a step-by-step fashion. This changed completely the prognosis of the patient. Timely chemotherapy and stem cell transplantation led to an improvement in clinical status, biomarkers, and in a regression of amyloid myocardial infi ltration showed by imaging.

P4545ACUTE HF score: a new multi-parametric score for the prognostication of acute heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G E Mandoli ◽  
G De Carli ◽  
M C Pastore ◽  
L Rizzo ◽  
C Nannelli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Multivariate Analysis ◽  
Acute Heart Failure ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Left Ventricular ◽  
Non Invasive ◽  
Blood Tests ◽  
Icu Stay ◽  
Previous Stroke

Abstract Background Prognosis of patients with acute heart failure (AHF) and different etiologies remains a challenging issue for the Cardiologist. Purpose We aimed to evaluate clinical and echocardiographic indexes and blood tests values of patients admitted to Intensive Care Unit (ICU) for AHF to test their capability to predict events at short-, medium- and long-term follow-up. Methods We retrospectively enrolled 830 patients who entered the ICU of our third-level hospital between 2010 and 2013 for AHF. Exclusion criteria included: active malignances, heart transplantation, patients with left ventricular assist device. We evaluated in each subject: cause of admission, medical history, chest congestion severity at admission, blood tests, echocardiographic parameters and administered drugs during in-hospital stay. Primary endpoints included: mortality rate at 30 days, 6 months and 5 years after dismission, days of ICU stay and cardiology ward stay. Indexes with statistical significance at univariate analysis, were then tested by multivariate analysis. Results The study population (average age 72.2±13 y) had an ejection fraction (EF) 36±12% at ICU admission. Best predictors of prognosis in the populations, after multivariate analysis, resulted to be: renal failure, EF, age, mitral regurgitation (MR) more than mild, use of non-invasive ventilation support during ICU stay, previous stroke or transient ischemic attack (TIA). With these indexes, we created a multi-parametric prognostic score composed by: 0.7*[age >76 years] + 1.4*[plasmatic creatinine >2mg/dl] + 0.8*[non-invasive mechanical ventilation] + 0.9*[previous stroke/TIA] + 0.8*[EF <30%] + + 0.7*[previous hospitalization for AHF] + 0.5*[moderate/severe MR]. According to the score, we stratified the population in 3 tertiles with increasing mortality risk: low if <1.5, medium if 1.5–3, high risk if >3 (Figure 1). At ROC curve analysis, the score showed a greater prognostic accuracy than each parameter (30 days AUC 0.75, 6 months AUC 0.78, 5 years AUC 0.79). Figure 1 Conclusions A combined clinical, humoral and echocardiographic score could represent a new tool in the prognostication of patients with AHF since the admission in ICU.

scholarly journals Article Commentary: Acute Heart Failure: Is it Peripartum Cardiomyopathy or Not?

2013 ◽  
Vol 6 (1) ◽  
pp. 42-44
Author(s):  
Katrin Bachelier-Walenta ◽  
Denise Hilfiker-Kleiner ◽  
Karen Sliwa
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Peripartum Cardiomyopathy ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Life Threatening

Peripartum cardiomyopathy (PPCM) is a potentially life-threatening disease that occurs in women of childbearing age.

IMPLANTABLE SENSORS TO ASSESS CARDIAC FUNCTION

2006 ◽  
Vol 06 (01) ◽  
pp. 81-89 ◽  
Author(s):  
G. PLICCHI ◽  
E. MARCELLI ◽  
L. CERCENELLI
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiac Function ◽  
Therapeutic Agents ◽  
Careful Consideration ◽  
Implantable Sensors ◽  
End Points ◽  
Mortality And Morbidity ◽  
Heart Failure Care ◽  
Early Results

The quest to discover effective methodologies to monitor the course of disease and response to therapeutic agents in patients with chronic heart failure continues. Clinical trials of specific therapeutic agents have shown efficacy in large groups of patients, but the outcome even with the most effective agents is recognized to be heterogeneous for largely unexplained reasons. The idea that the treatment of individual patients with heart failure could be guided by serial measurements of surrogate end points for mortality and morbidity remains attractive to clinicians. A new approach for clinicians is the guiding of heart failure care by hemodynamic implantable sensors, and in this paper, a brief review of the implantable technologies available to assess cardiac function for monitoring the course of chronic heart failure (CHF) is presented. Early results suggest that measurements arising from these implantable devices should help in guiding the long-term management of CHF patients. Careful consideration of measurements to make, end points to assess, and therapy in control patients will be essential in validating new approaches.

Sign in / Sign up

Export Citation Format

Share Document