Document Detail


Acute left ventricular dysfunction in the critically ill.
MedLine Citation:
PMID:  20605820     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acute left ventricular (LV) dysfunction is common in the critical care setting and more frequently affects the elderly and patients with comorbidities. Because of increased mortality and the potential for significant improvement with early revascularization, the practitioner must first consider acute coronary syndrome. However, variants of stress (takotsubo) cardiomyopathy may be more prevalent in ICU settings than previously recognized. Early diagnosis is important to direct treatment of complications of stress cardiomyopathy, such as dynamic LV outflow tract obstruction, heart failure, and arrhythmias. Global LV dysfunction occurs in the critically ill because of the cardio-depressant effect of inflammatory mediators and endotoxins in septic shock as well as direct catecholamine toxicity. Tachycardia, hypertension, and severe metabolic abnormalities can independently cause global LV dysfunction, which typically improves with addressing the precipitating factor. Routine troponin testing may help early detection of cardiac injury and biomarkers could have prognostic value independent of prior cardiac disease. Echocardiography is ideally suited to quantify LV dysfunction and determine its most likely cause. LV dysfunction suggests a worse prognosis, but with appropriate therapy outcomes can be optimized.
Authors:
Anand Chockalingam; Ankit Mehra; Smrita Dorairajan; Kevin C Dellsperger
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review    
Journal Detail:
Title:  Chest     Volume:  138     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-07     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  198-207     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Missouri School of Medicine, MO, USA. chockalingama@health.missouri.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Biological Markers / blood
Critical Illness*
Disease Progression
Echocardiography
Heart Catheterization
Humans
Incidence
Inpatients
Intensive Care Units
Severity of Illness Index
Survival Rate
Ventricular Dysfunction, Left* / diagnosis,  epidemiology,  physiopathology
Chemical
Reg. No./Substance:
0/Biological Markers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Hepatitis B virus-related polyarteritis nodosa presenting with multiple lung nodules and cavitary le...
Next Document:  Ash wednesday.