Cardiogenic Shock in Patients with Advanced Chronic Heart Failure

Guerrero‐Miranda, Cesar; Hall, Shelley

doi:10.14797/mdcj-16-1-22

Cited by 18 publications

(11 citation statements)

References 16 publications

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“…One of the common subsequent exanthems is jugular venous distension, which also can be seen. Due to decreased right CO, decreased LV filling from impaired ventricular interdependence is seen [ 48 , 49 , 50 ].…”

Section: Signs and Symptomsmentioning

confidence: 99%

Keep the Right in Mind—A Focused Approach to Right Ventricle-Predominant Cardiogenic Shock

Copeland

Fardman

Furer

2023

Life

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Cardiogenic shock (CS) remains a highly lethal condition despite many efforts and new interventions. Patients presenting with a rapid onset of hemodynamic instability and subsequent collapse require prompt and appropriate multimodality treatment. Multiple etiologies can lead to heart failure and subsequent shock. As the case prevalence of heart failure increases worldwide, it is of great importance to explore all manners and protocols of presentation and treatment present. With research primarily focusing on CS due to cardiac left-sided pathology, few assessments of right-sided pathology and the subsequent clinical state and treatment have been conducted. This review aims to present an in-depth assessment of the currently available literature, assessing the pathophysiology, presentation and management of CS patients due to right heart failure.

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Section: Signs and Symptomsmentioning

confidence: 99%

Keep the Right in Mind—A Focused Approach to Right Ventricle-Predominant Cardiogenic Shock

Copeland

Fardman

Furer

2023

Life

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“…All patients were either on the transplant list or urgently referred for evaluation of advanced therapies. All participants had rapidly developed, or worsening, signs and symptoms of HF with severe clinical deterioration according to INTERMACS profile (Interagency Registry for Mechanically Assisted Circulatory Support) [17], that stratifies AdHF patients based on the severity of their condition and anticipate those who will gain benefit from expedited temporary MCS [16]. All patients were either with impending or with established cardiogenic shock and they were referred to our CICU for urgent placement of tMCS.…”

Section: Study Populationmentioning

confidence: 99%

“…Additionally, prolonged IABP support in patients with AdHF has been shown to improve hemodynamics and peripheral organ function [15]. In patients with AdHF-CS the landscape is even murkier as the data are more limited, have not been widely studied, and are largely unspecified, compared to the extensive reports on the use of the intra-aortic pump in patients with AMI-CS [16].…”

Section: Introductionmentioning

confidence: 99%

IABP as a Bridge to Decision: A Less Aggressive but Still Effective Approach in Advanced HF Patients with Cardiogenic Shock

2023

J Nurs Women’s Health

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In this study, we evaluated the effectiveness of Intra-aortic balloon pump (IABP) therapy in improving hemodynamics and peripheral organ function in advanced heart failure (AdHF) patients who were admitted to the Cardiac Intensive Care (CICU) of a tertiary, high-volume, transplant center with impending or established cardiogenic shock.Hundred-four patients were studied their mean age of was 44 ± 12 years, 76 of them (73.08%) were male. All patients underwent IABP therapy. The median time on IABP support for the entire cohort was 13 days (3 -41.25). The survival rate was 87.62% (88 patients). We observed our cohort's significant improvement in the hemodynamics after right heart catheterization with a decrease of the right atrium pressure (p <0. 0001), PA pressure (p<0.001), and pulmonary capillary wedge pressure (p<0.001)). There was also a significant decrease in the NT-proBNP levels (p<0.0001), and improvement in renal function (e GFR (p<0.0001), and urea levels (p<0.001). Sixteen patients (15.38%) ended up in CICU on IABP. We found a significant correlation of death with NT-proBNP levels (p< 0.0014), renal function (p< 0.001), and application of renal dialysis (p< 0.0001), intubation (p<0.006), and with the value of 24-hour lactic acid (p<0.0001).IABP was an effective initial intervention for AdHF patients experiencing severe clinical deterioration. It was a first-line method of managing patients as a bridge to decision for further therapies with positive clinical response in improving their hemodynamics and peripheral organ function.

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“…Patients with advanced HF have lower cardiac reserve, higher biventricular filling pressures, and a greater degree of anaerobic metabolism as compared to cardiogenic shock patients with acute myocardial infarction. 16,17 A recent consensus statement by the Society of Cardiovascular Angiography and Intervention proposes a classification schema to identify the severity of cardiogenic shock, and helps rapidly identify critically ill patients who may benefit from temporary MCS. 18 The universal initial therapy for cardiogenic shock in stage D HF consists of inotropic therapy, often combined with vasodilators (to decrease afterload).…”

Section: Cardiogenic Shock In Stage D Heart Failurementioning

confidence: 99%

Mechanical Circulatory Support in Advanced Heart Failure

Arora

Atreya²

2021

Indian Journal of Clinical Cardiology

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Advanced heart failure (HF) with persistent and progressive clinical decline despite maximal medical therapy portends a high mortality in the absence of advanced therapies, such as ventricular assist devices or heart transplantation. A subset of these advanced HF patients deteriorates into refractory cardiogenic shock, that is challenging to manage with vasoactive agents alone. Temporary mechanical circulatory support (MCS) device options have evolved over the years and provide a viable option to rescue and rest the myocardium of patients in cardiogenic shock. The goal of such therapy is to serve as bridge to recovery, or more often, a bridge to durable advanced therapies. For those patients with progressive advanced HF despite extensive medical therapy, durable MCS devices (ventricular assist devices) are available when heart transplantation is not feasible. In this article, we review currently available temporary and durable MCS devices, with a focus on their hemodynamic profiles, to inform optimal device selection for patients with advanced HF.

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Cardiogenic Shock in Patients with Advanced Chronic Heart Failure

Cited by 18 publications

References 16 publications

Keep the Right in Mind—A Focused Approach to Right Ventricle-Predominant Cardiogenic Shock

Keep the Right in Mind—A Focused Approach to Right Ventricle-Predominant Cardiogenic Shock

IABP as a Bridge to Decision: A Less Aggressive but Still Effective Approach in Advanced HF Patients with Cardiogenic Shock

Mechanical Circulatory Support in Advanced Heart Failure

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