Abstract
Unstable heart failure represents the clinical state of progressively worsening or decompensated heart failure, which, if not improved within a reasonable time (usually minutes to hours), often evolves into markedly symptomatic heart failure, cardiovascular collapse, and shock or death. The clinical settings include, among others, the patient who arrives in the emergency room in acute pulmonary edema, the patient with postinfarction cardiogenic shock, the patient who cannot be weaned from cardiopulmonary bypass after cardiac surgery, or the chronic heart failure patient who is experiencing a rather abrupt worsening of symptoms. Most patients with unstable heart failure must be approached with a certain sense of urgency.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Goldberger JJ, Peled HB, Stroh JA, et al.: Prognostic factors in acute pulmonary edema. Arch Intern Med 1986,146:489–493.
Forrester JS, Diamond G, Chatterjee K, et al.: Medical therapy of acute myocardial infarction by application of hemodynamic subsets. N Engl J Med 1976, 295:1356–1362,1404–1413.
Goldberg RJ, Yarzebski J, Lessard D, Gore JM: A two-decades (1975 to 1995) long experience in the incidence, in-hospital and long-term case fatality rates of acute myocardial infarction: a community-wide perspective. J Am Coll Cardiol 1999, 33: 1533–1539.
Guidry UC, Evans JC, Larson MG, et al.: Temporal trends in event rates after Q wave myocardial infarction: the Framingham Heart Study. Circulation 1999,100:2054–2059.
Gan SC, Beaver SK, Houck PM, et al.: Treatment of acute myocardial infarction and 30-day mortality among women and men. N Engl J Med 2000, 343:8–15.
Heart Failure Guidelines Committed of the American College of Cardiology/American Heart Association: Guidelines for the evaluation and management of heart failure. J Am Coll Cardiol 1995, 26: 1376–1398.
Packer M, Cohn JN, Abraham WT, et al.: Consensus recom-mendations for the management of chronic heart failure. Am J Cardiol 1999, 83:1A–79A.
Franciosa JA, Guiha NH, Limas CL, et al.: Improved left ventricular function during nitroprusside infusion in acute myocardial infarction. Lancet 1972,1:650–654.
Leier CV, Bambach D, Thompson MJ, et al.: Central and regional hemodynamic effects of intravenous isosorbide dinitrate, nitro-glycerin, and nitroprusside in patients with congestive heart failure. Am J Cardiol 1981, 48:1115–1123.
Mills RM, LeJeuntel TH, Horton DP, et al.: Sustained hemodynamic effects of nesiritide (human b-type natriuretic peptide) in heart failure: a randomized, double-blind, placebo-controlled clinical trial. J Am Coll Cardiol 1999, 34:155–162.
Colucci WS, Elkayan U, Horton DP, et al.: Intravenous nesiritide, a natriuretic peptide, in the treatment of decompensated heart failure. N Engl J Med 2000, 343:246–253.
Leier CV: Acute inotropic support: intravenously administered positive inotropic drugs. In Cardiotonic Drugs, edn 2. Edited by Leier CV. New York: Marcel Dekker; 1991: 63–106.
Loeb HS, Winslow EBJ, Rahimtoola SH, et al.: Acute hemodynamic effects of dopamine in patients with shock. Circulation 1971, 44:163–173.
Holzer J, Karliner JS, O’Rourke RA, et al.: Effectiveness of dopamine in patients with cardiogenic shock. Am J Cardiol 1973, 32:79–84.
Leier CV, Webel J, Bush CA: The cardiovascular effects of the continuous infusion of dobutamine in patients with severe cardiac failure. Circulation 1977, 56: 468–472.
Leier CV, Heban PT, Huss P, et al.: Comparative systemic and regional hemodynamic effects of dopamine and dobutamine in patients with heart failure. Circulation 1978, 58:466–475.
Francis GS, Sharma B, Hodges M: Comparative hemodynamic effects of dopamine and dobutamine in patients with acute cardiogenic circulatory collapse. Am Heart J 1982, 103: 995–1000.
Jaski B, Fifer MA, Wright RF, et al.: Positive inotropic and vasodilator actions of milrinone in patients with severe congestive heart failure. J Clin Invest 1985, 75:643–649.
Sander CA, Buckley MJ, Leinbach RC, et al.: Mechanical circula-tory assistance: current status and experience with combining circulatory assistance, emergency coronary angiography, and acute myocardial revascularization. Circulation 1972, 45:1291–1313.
Bardet J, Masquet C, Kahn J-C, et al.: Clinical and hemodynamic results of intra-aortic balloon counterpulsation and surgery for cardiogenic shock. Am Heart J 1977, 93:280–288.
Johnson SA, Scanlon PJ, Loeb HS, et al.: Treatment of cardiogenic shock in myocardial infarction by intra-aortic balloon counter-pulsation and surgery. Am J Med 1977, 62:687–692.
Kovack PJ, Rasak MA, Bates ER, et al.: Thrombolysis plus aortic counterpulsation with and without reperfusion for myocardial infarction shock. Circulation 1980, 61:1105–1112.
Torchiana DF, Hirsch G, Buckley MJ, et al.: Intraaortic balloon pumping for cardiac support: trends in practice and outcome, 1968 to 1995. J Thorac Cardiovasc Surg 1997,113:758.
Califf RM: Ten years of benefit from a one-hour intervention. Circulation 1998, 98: 2649–2651.
Rothbaum DA, Linnemeier TJ, Landin RJ, et al.: Emergency percutaneous transluminal coronary angioplasty in acute myocardial infarction: a 3 year experience. J Am Coll Cardiol 1987, 10:264–272.
Lee L, Bates ER, Pitt B, et al.: Percutaneous transluminal coronary angioplasty improves survival in acute myocardial infarction complicated by cardiogenic shock. Circulation 1988, 78:1345–1351.
Ellis SG, O’Neill WW, Bates ER, et al.: Implications of patient triage from survival and left ventricular functional recovery analyses in 500 patients treated with coronary angioplasty for acute myocardial infarction. J Am Coll Cardiol 1989, 13:1251–1259.
Lee L, Erbel R, Brown TM, et al.: Multicenter registry of angioplasty therapy of cardiogenic shock: initial and long-term survival. J Am Coll Cardiol 1991,17:599–603.
Hochman JS, Boland J, Sleeper LA, et al.: Current spectrum of cardiogenic shock and effect of early revascularization on mortality. Circulation 1995, 91:873–881.
Lamas GA, Glaker GA, Mitchell G, et al.: Effect of infarct artery patency on prognosis after acute myocardial infarction. Circulation 1995, 92:1101–1109.
Holmes DR Jr, Bates ER, Kleiman NS, et al.: Contemporary reperfusion therapy for cardiogenic shock: the Gusto-1 trial experience. J Am Coll Cardiol 1995, 26:668–674.
Berger PB, Holmes DR, Stebbins AL, et al. for the Gusto-1 Investigators: Impact of an aggressive invasive catheterization and revascularization strategy on mortality in patients with cardiogenic shock in the Gusto-1 trial. Circulation 1997, 96: 122–127.
Dangas G, Stone GW: Primary mechanical reperfusion in acute myocardial infarction: the United States experience. Semin Intervent Cardiol 1999, 4: 21–33.
Hochman JS, Sleeper LA, Webb JG, et al.: Early revascularization in acute myocardial infarction complicated by cardiogenic shock: should we emergently revascularize occluded coronaries for cardiogenic shock. N Engl J Med 1999, 341:625–634.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer Science+Business Media New York
About this chapter
Cite this chapter
Leier, C.V., Orsinelli, D.A. (2002). Unstable Heart Failure. In: Colucci, W.S. (eds) Atlas of Heart Failure. Current Medicine Group, London. https://doi.org/10.1007/978-1-4615-6490-4_9
Download citation
DOI: https://doi.org/10.1007/978-1-4615-6490-4_9
Publisher Name: Current Medicine Group, London
Print ISBN: 978-1-4615-6492-8
Online ISBN: 978-1-4615-6490-4
eBook Packages: Springer Book Archive