Cardiac Tamponade and Pericardiocentesis
Pericardiocentesis is an important diagnostic and therapeutic procedure. In the setting of cardiac tamponade, pericardiocentesis can rapidly improve hemodynamics, and in cases of diagnostic uncertainty, pericardiocentesis allows for fluid analysis to aid in diagnosis. In contemporary practice, the widespread availability of ultrasonography has made echocardiographic guidance the standard of care. Additional tools such as micropuncture technique, live ultrasonographic guidance, and adjunctive tools including fluoroscopy continue to advance and enhance procedural efficiency and safety. When performed by experienced operators...
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Zachary J. Il ’Giovine, Ann Gage, Andrew Higgins Source Type: research
Mechanical Circulatory Support in Cardiogenic Shock
Cardiogenic shock is a lethal condition with significant morbidity, characterized by myocardial insults leading to low cardiac output and ensuing systemic hypoperfusion. While mortality rates remain high, we have improved upon our recognition and definition of cardiogenic shock, now with an emphasis on defining stages of shock to help guide effective treatment strategies with either pharmacologic or mechanical circulatory support. In this review, the authors summarize these stages as well as discuss indications, function, selection, and troubleshooting of the various temporary mechanical circulatory support devices. (Sourc...
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Ian Persits, Ran Lee Source Type: research
Intermediate-Risk and High-Risk Pulmonary Embolism: Recognition and Management
Pulmonary embolism (PE) is the third most common cause of cardiovascular death. Every specialty of medical practitioner will encounter PE in their patients, and should be prepared to employ contemporary strategies for diagnosis and initial risk-stratification. Treatment of PE is based on risk-stratification, with anticoagulation for all patients, and advanced modalities including systemic thrombolysis, catheter-directed therapies, and mechanical circulatory supports utilized in a manner paralleling PE severity and clinical context. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Drew A. Birrenkott, Christopher Kabrhel, David M. Dudzinski Source Type: research
Acute Heart Valve Emergencies
Within the cardiac intensive care unit, prompt recognition of severe acute valvular lesions is essential because hemodynamic collapse can occur rapidly, especially when cardiac chambers have not had time for compensatory remodeling. Within this context, optimal medical management, considerations for temporary mechanical circulatory support and decisive treatments strategies are addressed. Fundamental concepts include an appreciation for how sudden changes in flow and pressure gradients between cardiac chambers can impact hemodynamic and echocardiographic findings differently compared to similarly severe chronic lesions, as...
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Ryan R. Keane, Venu Menon, Paul C. Cremer Source Type: research
Complex Heart –Lung Ventilator Emergencies in the CICU
This review aims to enhance the comprehension and management of cardiopulmonary interactions in critically ill patients with cardiovascular disease undergoing mechanical ventilation. Highlighting the significance of maintaining a delicate balance, this article emphasizes the crucial role of adjusting ventilation parameters based on both invasive and noninvasive monitoring. It provides recommendations for the induction and liberation from mechanical ventilation. Special attention is given to the identification of auto-PEEP (positive end-expiratory pressure) and other situations that may impact hemodynamics and patients ’ ...
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Mireia Padilla Lopez, Willard Applefeld, Elliott Miller, Andrea Elliott, Courtney Bennett, Burton Lee, Christopher Barnett, Michael A. Solomon, Francesco Corradi, Alessandro Sionis, Eduardo Mireles-Cabodevila, Guido Tavazzi, Carlos L. Alviar Source Type: research
The Pharmacologic Management of Cardiac Arrest
This article covers the current state of evidence for the effectiveness of the vasopressor epinephrine and the combination of vasopressin-steroids-epinephrine and antiarrhythmic medications amiodarone and lidocaine and reviews the role of other med ications such as calcium, sodium bicarbonate, magnesium, and atropine in cardiac arrest care. We additionally review the role of β-blockers for refractory pulseless ventricular tachycardia/ventricular fibrillation and thrombolytics in undifferentiated cardiac arrest and suspected fatal pulmonary em bolism. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Amandeep Singh, Megan Heeney, Martha E. Montgomery Source Type: research
Cardiac Arrest in Special Populations
Best practices in cardiac arrest depend on continuous high-quality chest compressions, appropriate ventilatory management, early defibrillation of shockable rhythms, and identification and treatment of reversible causes. Although most patients can be treated according to highly vetted treatment guidelines, some special situations in cardiac arrest arise where additional skills and preparation can improve outcomes. Situations covered in this section involve cardiac arrest in context of electrical injuries, asthma, allergic reactions, pregnancy, trauma, electrolyte imbalances, toxic exposures, hypothermia, drowning, pulmonar...
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Ravi W. Sumer, William A. Woods Source Type: research
Out-of-Hospital Cardiac Arrest
This article focuses on the management of OHCA by EMS providers. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Ryan B. Gerecht, Jose V. Nable Source Type: research
Impact of Coronavirus Disease 2019 Pandemic on Cardiac Arrest and Emergency Care
The incidence of both out-of-hospital and in-hospital cardiac arrest increased during the coronavirus disease 2019 (COVID-19) pandemic. Patient survival and neurologic outcome after both out-of-hospital and in-hospital cardiac arrest were reduced. Direct effects of the COVID-19 illness combined with indirect effects of the pandemic on patient ’s behavior and health care systems contributed to these changes. Understanding the potential factors offers the opportunity to improve future response and save lives. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Murtaza Bharmal, Kyle DiGrande, Akash Patel, David M. Shavelle, Nichole Bosson Source Type: research
Cardiac Emergencies
CARDIOLOGY CLINICS (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Authors: Ran Lee Source Type: research
Copyright
ELSEVIER (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Source Type: research
Contributors
JAMIL A. ABOULHOSN, MD, FACC, FSCAI (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Source Type: research
Contents
Ran Lee (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Source Type: research
Forthcoming Issues
Update in Structural Heart Interventions (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 16, 2024 Category: Cardiology Source Type: research
Electrosurgery in Structural Heart Interventions
Electrosurgery has emerged as a groundbreaking tool in the field of structural cardiac interventions, revolutionizing the approach to complex cardiac conditions. This review delves into the core principles, procedural techniques, outcomes, and potential challenges associated with various electrosurgical procedures within the realm of structural cardiology. Five key electrosurgical procedures performed in complex structural interventions are highlighted in this review. They are the Transcaval Access, BASILICA, LAMPOON, ELASTIC/ELASTA-Clip, and SESAME procedures. While these electrosurgery procedures hold promise and have de...
Source: Cardiology Clinics - April 3, 2024 Category: Cardiology Authors: Ajoe John Kattoor, Vijay Iyer Source Type: research
