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The Management of Pump Failure

  • Kanu Chatterjee
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 97)

Abstract

Pump failure has emerged as the principal cause of death in patients with acute myocardial infarction, since mortality from primary dysrhythmias has declined as a result of advances in their detection and management. The severity of pump failure is related, in general, to the total amount of nonfunctioning myocardium, which includes recently infarcted segments, scar tissue from remote infarction, and ischemic but viable myocardial segments. If one can decrease the extent of myocardial injury and improve function of ischemic myocardium, the severity of pump failure is expected to be less and immediate, and the late prognosis is expected to be better. Potential exists for decreasing the “infarct size” and improving global and regional myocardial function with reperfusion therapy. Thus, thrombolytic therapy, primary angioplasty, or both deserve consideration for the management of pump failure complicating myocardial infarction. However, recanalization of the infarct-related coronary artery is not always associated with preservation of ischemic myocardium; furthermore, even when salvage of ischemic myocardium is achieved, its function may not improve immediately because of the phenomenon of “stunned myocardium” [1].

Keywords

Cardiac Output Acute Myocardial Infarction Cardiogenic Shock Systemic Vascular Resistance Pulmonary Capillary Wedge Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Kluwer Academic Publishers 1989

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  • Kanu Chatterjee

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