One-third to one-half of patients with chronic, dilated heart failure will die suddenly or be resuscitated from a cardiac arrest or sustained ventricular tachycardia (VT).1–3 Implantable cardioverter-defibrillators (ICDs) offer excellent protection from sudden death by providing effective termination of the arrhythmia when it occurs, but they are not without problems. Approximately one-third of...

Pulmonary arterial hypertension and hypoxemia constitute a significant cause of postoperative right heart failure and mortality. Timely administration of inhaled nitric oxide (iNO) can improve hemodynamic parameters and oxygenation in patients undergoing heart and/or lung transplantation and various high-risk cardiac procedures involving coronary artery bypass grafting and/or left ventricular a...

We illustrate the valuable information provided by echocardiography for hemodynamic monitoring and for optimizing ventilatory strategies, during ARDS. Although the transthoracic and the transesophageal routes can be used, we always prefer, in the absence of contraindications, to perform transesophageal echocardiography. ARDS includes numerous affections which brutally damage the interface betwe...

RADIOGRAPHIC evidence of right ventricular enlargement with bulging of the main pulmonary artery13 and electroveetoreardiographic signs of right ventricular preponderance2' 4-6 are common findings in people born and living at high altitudes. Anatomically, the existence of right ventricular hypertrophy has been demonstrated both in adults7-9 and children.10 Recently, hemodynamic studies have dis...

For patients with cardiogenic shock, delaying surgery mechanical circulatory support is reported to yield better outcomes than emergency surgery. We report on an 82-year-old man diagnosed vertebral osteomyelitis concomitant infective endocarditis. Chest radiographs revealed a growing abscess, which resulted in aorto-right ventricular fistula. Providing Impella allowed for hemodynamic stabilizat...

Appropriate heart rate in a failing pulmonary ventricle remains unknown, particularly congenital disease with unique hemodynamics. A 71-year-old male repaired tetralogy of Fallot and pacemaker for sinus node dysfunction suffered from failure symptoms preserved left ventricular function. Simply changing the pacemaker’s lower 60 to 75 bpm, New York Heart Association classification improved III II...

A 58-year-old woman underwent aortic valve replacement. On the second postoperative day the patient referred a sharply chest pain, and an emergent coronary angiography revealed total occlusion of the right coronary artery. An intra-aortic ballon pump was placed and the patient underwent emergent off-pump coronary revascularization of the right coronary artery. Five hours later, due to unstable ...

To understand better the hemodynamic effects caused by propranolol, its effect on the geometry of left ventricular contraction was studied in ten subjects, four with angiographic evidence of coronary artery disease and six without demonstrable heart disease. Heart rate was controlled in four subjects with right atrial pacing. After 5 mg of intravenous propranolol, there were decreases in heart ...