Document Detail

Congestion in acute heart failure syndromes: an essential target of evaluation and treatment.
MedLine Citation:
PMID:  17113398     Owner:  NLM     Status:  MEDLINE    
Patients with acute heart failure syndromes (AHFS) typically present with signs and symptoms of systemic and pulmonary congestion at admission. However, elevated left ventricular (LV) filling pressures (hemodynamic congestion) may be present days or weeks before systemic and pulmonary congestion develop, resulting in hospital admission. This "hemodynamic congestion," with or without clinical congestion, may have deleterious effects including subendocardial ischemia, alterations in LV geometry resulting in secondary mitral insufficiency, and impaired cardiac venous drainage from coronary veins resulting in diastolic dysfunction. It is possible that these hemodynamic abnormalities in addition to neurohormonal activation may contribute to LV remodeling and heart failure progression. Approximately 50% of patients admitted for AHFS are discharged with persistent symptoms and/or minimal or no weight loss in spite of the fact that the main reason for admission was clinical congestion. Accordingly, the assessment and management of pulmonary and systemic congestion in these patients require reevaluation.
Mihai Gheorghiade; Gerasimos Filippatos; Leonardo De Luca; John Burnett
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  119     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-20     Completed Date:  2007-06-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S3-S10     Citation Subset:  AIM; IM    
Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
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MeSH Terms
Acute Disease
Blood Pressure
Blood Volume
Dyspnea / etiology
Edema / etiology
Heart Failure / complications,  physiopathology*,  therapy
Ventricular Dysfunction, Left / diagnosis,  physiopathology*
Ventricular Remodeling / physiology
Water-Electrolyte Balance
Comment In:
Am J Med. 2006 Dec;119(12 Suppl 1):S1-2   [PMID:  17113394 ]

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

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