Advertisement

Unstable Heart Failure

  • Carl V. Leier
  • David A. Orsinelli

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.

Keywords

Heart Failure Acute Myocardial Infarction Chronic Heart Failure Left Anterior Descend Cardiac Resynchronization Therapy 
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.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Goldberger JJ, Peled HB, Stroh JA, et al.: Prognostic factors in acute pulmonary edema. Arch Intern Med 1986,146:489–493.PubMedCrossRefGoogle Scholar
  2. 2.
    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.Google Scholar
  3. 3.
    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 Ant Coll Cardiol 1999, 33: 1533–1539.CrossRefGoogle Scholar
  4. 4.
    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.PubMedCrossRefGoogle Scholar
  5. 5.
    Sanborn TA, Sleeper LA, Webb JG, et al.: Correlates of one-year survival in patients with cardiogenic shock complicating acute myocardial infarction. J Am Coll Cordial 2003, 42:1373–1379.CrossRefGoogle Scholar
  6. 6.
    Heart Failure Guidelines Committee of the American College of Cardiology/American Heart Association: Guidelines for the evaluation and management of heart failure. J Am Call Cardiol 1995, 26: 1376–1398. (revised: 2001, 38:2101–2113).Google Scholar
  7. 7.
    HFSA Guidelines Committee: HFSA guidelines for the management of patients with heart failure caused by left ventricular systolic dysfunction. J Cardiac Failure 1999, 5: 357–382.CrossRefGoogle Scholar
  8. Franciosa JA, Guiha NH, Limas CL, et al.: Improved left ventricular function during nitroprusside infusion in acute myocardial infarction. Lancet 1972,1:650–654.PubMedCrossRefGoogle Scholar
  9. 9.
    Leier CV, Bambach D, Thompson MJ, et al.: Central and regional hemodynamic effects of intravenous isosorbide dinitrate, nitroglycerin, and nitroprusside in patients with congestive heart failure. Am J Cardiol 1981, 48:1115–1123.PubMedCrossRefGoogle Scholar
  10. 10.
    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 Call Cardiol 1999, 34:155–162.CrossRefGoogle Scholar
  11. 11.
    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.PubMedCrossRefGoogle Scholar
  12. 12.
    Leier CV, Binkley PF: Parenteral inotropic support for advanced heart failure. Prag Cardiovasc Dis 1998, 41: 207–214.CrossRefGoogle Scholar
  13. 13.
    Loeb HS, Winslow EBJ, Rahimtoola SH, et al.: Acute hemodynamic effects of dopamine in patients with shock. Circulation 1971, 44:163–173.PubMedCrossRefGoogle Scholar
  14. 14.
    Holzer J, Karliner JS, O’Rourke RA, et al.: Effectiveness of dopamine in patients with cardiogenic shock. Am J Cordial 1973, 32:79–84.CrossRefGoogle Scholar
  15. 15.
    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.PubMedCrossRefGoogle Scholar
  16. 16.
    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.PubMedCrossRefGoogle Scholar
  17. 17.
    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.PubMedCrossRefGoogle Scholar
  18. 18.
    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.PubMedCrossRefGoogle Scholar
  19. 19.
    Sander CA, Buckley MJ, Leinbach RC, et al.: Mechanical circulatory assistance: current status and experience with combining circulatory assistance, emergency coronary angiography, and acute myocardial revascularization. Circulation 1972, 45:1291–1313.Google Scholar
  20. 20.
    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.PubMedCrossRefGoogle Scholar
  21. 21.
    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.PubMedCrossRefGoogle Scholar
  22. 22.
    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.Google Scholar
  23. 23.
    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 Surer 1997, 113:758.CrossRefGoogle Scholar
  24. 24.
    Califf RM: Ten years of benefit from a one-hour intervention. Circulation 1998, 98: 2649–2651.PubMedCrossRefGoogle Scholar
  25. 25.
    Rothbaum DA, Linnemeier TJ, Landin RJ, et al.: Emergency percutaneous transluminal coronary angioplasty in acute myocardial infarction: a 3 year experience. J Ant Coll Cardiol 1987, 10:264–272.CrossRefGoogle Scholar
  26. 26.
    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.PubMedCrossRefGoogle Scholar
  27. 27.
    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 Cordial 1989, 13: 1251–1259.CrossRefGoogle Scholar
  28. 28.
    Lee L, Erbel R, Brown TM, et al.: Multicenter registry of angioplasty therapy of cardiogenic shock: initial and long-term survival. J Am Call Cardiol 1991, 17:599–603.CrossRefGoogle Scholar
  29. 29.
    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.PubMedCrossRefGoogle Scholar
  30. 30.
    Lamas GA, Glaker GA, Mitchell G, et al.: Effect of infarct artery patency on prognosis after acute myocardial infarction. Circulation 1995, 92:1101–1109.PubMedCrossRefGoogle Scholar
  31. 31.
    Holmes DR Jr, Bates ER, Kleiman NS, et al.: Contemporary reperfusion therapy for cardiogenic shock: the Gusto-1 trial experience. J Am Coll Cordial 1995, 26:668–674.CrossRefGoogle Scholar
  32. 32.
    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.PubMedCrossRefGoogle Scholar
  33. 33.
    Dangas G, Stone GW: Primary mechanical reperfusion in acute myocardial infarction: the United States experience. Semin Intervent Cardiol 1999, 4: 21–33.Google Scholar
  34. 34.
    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.PubMedCrossRefGoogle Scholar
  35. 35.
    Abraham WT, Fisher WG, Smith AL, it al.: Cardiac resynchronization in chronic heart failure. N Engl J Med 2002, 346: 1845–1853.PubMedCrossRefGoogle Scholar
  36. 36.
    Young JB, Abraham WT, Smith AL, et al.: Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced heart failure. JAMA 2003, 289:2685–2694.PubMedCrossRefGoogle Scholar
  37. 37.
    Rose EA, Gelijns AC, Moskowitz AJ, et al.: Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med 2001, 345:1435–1443.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2005

Authors and Affiliations

  • Carl V. Leier
  • David A. Orsinelli

There are no affiliations available

Personalised recommendations