Introduction Risk factors or markers for mortality in heart failure (HF) include a long list of clinical parameters, including history, physical examination, laboratory values, hemodynamics, cardiac structure and function, and…
Introduction Cardiogenic shock (CS) is a state of insufficient cardiac output and end-organ perfusion that can be the terminal phase of many different cardiac conditions, including acute coronary syndromes, arrhythmias,…
Introduction Deciding who should and who should not proceed with mechanical circulatory support (MCS)—including timing and device type—is one of the most difficult challenges in medicine. While there are now…
Introduction The term shock first appeared in the English medical literature in a translation by John Clarke of a French treatise on gunshot wounds by Henry LeDran in 1740, Traité…
Early mechanical circulatory support devices and technology development Establishing the Concept In the 1930s, Carrel and Lindbergh developed an in vitro artificial heart-like apparatus for keeping organs alive outside the…
Key Points 1. Cardiac patients and those who have had previous cardiac surgery often present for intrathoracic diagnostic or therapeutic noncardiac procedures. 2. Patients with coronary artery disease, valvular heart…
Key Points 1. The costs of healthcare are escalating. Goal-directed fluid therapy (GDT) and multimodal pain relief are ways to control cost while improving quality. 2. GDT is an integral…
Key Points 1. Major adverse cardiac events (MACEs) are relatively common in patients undergoing noncardiac surgical procedures. The incidence of perioperative myocardial infarction (PMI) is about 0.9%. However, a larger…
Key Points 1. Cardiac patients presenting for emergency noncardiac surgery have higher risk for perioperative morbidity and mortality. Emergency surgeries are associated with two to five times the risk of…
Key Points 1. Patients who present for cerebrovascular, aortic, or peripheral arterial interventions are at elevated risk for concomitant coronary artery disease. 2. A thorough preoperative assessment for cardiovascular disease…
