Left sided Heart Failure

Intended Learning Outcomes


Left sided Heart Failure
Describe the epidemiology and the importance of heart failure within intensive care medicine. Describe the pathophysiological responses of the failing heart, specifically the neurohormonal response and how these impact on the left ventricular pressure-volume loop. Classify the diverse causes of acute decompensated heart failure. Discuss the workup for a patient with acute heart failure describing the key features of clinical assessment and investigations. Outline the place for grading systems, prognostication and scoring systems for the patient with acute heart failure and their limitations. Outline the basic and advanced monitoring available for the critically unwell patient with acute heart failure including cardiac output monitoring. Describe the management of heart failure as outlined within the European Society of Cardiology Guidelines. Outline the physiological targets and standard organ support when treating the patient with acute heart failure. Describe the indications and timing for short term mechanical circulatory support in acute heart failure. Outline the haemodynamic goals and effects of mechanical circulatory support Describe the key characteristics of specific devices including, intra-aortic balloon pump (IABP), Impella, TandemHeart, Veno-Arterial Extracorporeal Membrane Oxygenation (VA ECMO). Discuss the role of long term mechanical circulatory support and heart transplantation.


Left sided Heart Failure
1.1 Adopts a structured and timely approach to the recognition, assessment and stabilisation of the acutely ill patient with disordered physiology 1.3 Manages the patient post-resuscitation 2.2 Undertakes timely and appropriate investigations 2.3 Describes indications for echocardiography (transthoracic / transoesophageal) 2.4 Performs electrocardiography (ECG / EKG) and interprets the results 2.9 Monitors and responds to trends in physiological variables 2.10 Integrates clinical findings with laboratory investigations to form a differential diagnosis 3.1 Manages the care of the critically ill patient with specific acute medical conditions 3.2 Identifies the implications of chronic and co-morbid disease in the acutely ill patient 3.3 Recognises and manages the patient with circulatory failure 4.4 Uses fluids and vasoactive / inotropic drugs to support the circulation 4.5 Describes the use of mechanical assist devices to support the circulation 5.17 Demonstrates a method for measuring cardiac output and derived haemodynamic variables

Faculty Disclosures:
The authors of this module have not reported any disclosures.