Heart failure clinics
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This article focuses on important advances in the science of cardiopulmonary resuscitation in the last decade that have led to a significant improvement in understanding the complex physiology of cardiac arrest and critical interventions for the initial management of cardiac arrest and postresuscitation treatment. Special emphasis is given to the basic simple ways to improve circulation, vital organ perfusion pressures, and the grave prognosis of sudden cardiac death.
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Heart failure clinics · Jul 2010
ReviewTreatment with iron of patients with heart failure with and without anemia.
Iron deficiency is a common cause of anemia in otherwise healthy individuals and plays an important role in the development of anemia within the heart failure patient population. Iron-deficient heart failure patients experience worse symptoms and are less exercise tolerant than those without iron deficiency. These symptoms may occur even before clinical anemia is evident. This article reviews studies of the benefits of the use of intravenous iron to treat iron deficiency in anemic and nonanemic heart failure patients and an overview of the physiology and pathophysiology of iron metabolism in chronic heart failure.
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Heart failure clinics · Jul 2009
ReviewMagnetic resonance imaging of pericardial disease and intracardiac thrombus.
Magnetic resonance is known to be a superior modality for the evaluation of pericardial disease and intracardiac masses because of its unmatched capacity for tissue characterization and high spatial resolution. New real-time sequences complement the standard morphologic imaging of the pericardium with dynamic image acquisitions that also can provide hemodynamic information indicative of constriction. Magnetic resonance also is becoming increasingly recognized as a superior modality for the detection and characterization of intracardiac thrombus. This article reviews the use of magnetic resonance imaging for the evaluation of pericardial disease and the detection of intracardiac thrombus, with particular emphasis on the newer pulse sequences currently available for cardiac imaging.
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Heart failure clinics · Apr 2009
ReviewRole of the pulmonary artery catheter in diagnosis and management of heart failure.
The pulmonary artery catheter will likely earn a place in the history of medicine as one of the most useful tools that shaped our understanding and management of various diseases. An intense assessment of its application in nonacute and nonshock decompensated heart failure has been provided by the ESCAPE trial, a landmark investigation that showed an overall neutral impact of pulmonary artery catheter-guided therapy over therapy guided by clinical evaluation and judgment alone. The current guidelines reserve the use of a pulmonary artery catheter for the management of refractory heart failure and select conditions. The pulmonary artery catheter remains a useful instrument in clinical situations when clinical and laboratory assessment alone is insufficient in establishing the diagnosis and pathophysiologic condition, and in guiding effective, safe therapy.