Editors Alan S Maisel MD Professor of Medicine Director, CCU and HF Program Department of Medicine and Cardiology VA Medical Center, University of California San Diego, California, USA Gerasimos S Filippatos MD FESC FHFA Professor of Cardiology Heart Failure Unit, Department of Cardiology Attikon University Hospital University of Athens, School of Medicine Athens, Greece
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Algorithms in Heart Failure
First Edition: Digital Version 2017
- Alan S Maisel MDProfessor of MedicineDirector, CCU and HF ProgramDepartment of Medicine and CardiologyVA Medical Center, University of CaliforniaSan Diego, California, USA
- Gerasimos S Filippatos MD FESC FHFAProfessor of CardiologyHeart Failure Unit, Department of CardiologyAttikon University HospitalUniversity of Athens, School of MedicineAthens, Greece
- Eric Adler MDAssociate Professor of MedicineDriector of Advanced Heart Failure and Cardiac TransplantationDepartment of MedicineUniversity of CaliforniaSan Diego, California, USA
- Nancy M Albert PhD CCNS CHFN CCRN NE-BC FAHA FCCM FAANAssociate Chief Nursing OfficerNursing Research and InnovationClinical Nurse SpecialistKaufman Center for HeartFailure, Heart and VascularInstitute, Cleveland ClinicCleveland, Ohio, USA
- Khwaja S Alim MDPracticing Internal MedicineSt. Martin Dominican HospitalLas Vegas, Nevada, USA
- Hermineh AraminMedical DoctorVA Medical CenterDepartment of CardiologySan Diego, California, USA
- Boris Arbit MDCardiology FellowDepartment of MedicineUniversity of California
- Kimberly C Atianzar MDFellow, Advanced CardiovascularImagingDepartment of Internal MedicineUniversity of CaliforniaSan Diego, California, USA
- Vasiliki Bistola MDConsultant CardiologistDepartment of CardiologyAttikon University HospitalAthens, Greece
- Daniel G Blanchard MD FACC FAHA FASEProfessor of MedicineDepartment of CardiovascularMedicineUC San Diego CardiovascularCenterSan Diego, California, USA
- Rudolf A de Boer MD PhD FESC FHFAProfessor of TranslationalCardiologyDepartment of CardiologyUniversity Medical CenterGroningenGroningen, Netherlands
- Jeffrey Chan MDResident PhysicianDepartment of AnesthesiologyUniversity of WashingtonSeattle, Washington, USA
- Anthony J Choi ABIMCardiologistDepartment of CardiologyNaval Medical CenterSan Diego, California, USA
- Lori B Daniels MD MAS FACCProfessor of MedicineDirector, Coronary Care UnitUniversity of CaliforniaSan Diego, California, USA
- Jason M Duran MD PhDResident PhysicianDepartment of MedicineUniversity of CaliforniaSan Diego, California, USA
- Jeremy EgnatiosMedical StudentDepartment of MedicineUniversity of CaliforniaSan Diego, California, USA
- Lothar Faber MD FESC FAHA FACCProfessor Department for CardiologyHeart and Diabetes Center NRWBad Oeynhausen, North Rhine-Westphalia, Germany
- Luna Gargani MD PhDCardiologist and ResearcherInstitute of Clinical PhysiologyNational Research CouncilPisa, Italy
- Erik A GreenMedical StudentTulane University School of MedicineNew Orleans, Louisiana, USA
- Meghana G Halkar MD FACPCardiology HospitalistDepartment of Cardiovascular MedicineMedStar/Cleveland Clinic Heart and Vascular Institute
- JT Heywood MDDirector, Advanced Heart Failure,Mechanical Circulatory Support ProgramDepartment of CardiologyScripps ClinicSan Diego, California, USA
- Affan B Irfan MD PhDClinical Cardiology FellowDepartment of General Cardiology and Department of PhysiologyUniversity of LouisvilleLouisville, Kentucky, USA
- Shiro Ishihara MDResearch AssociateDepartment of CardiologyNippon Medical School Musashi-Kosugi HospitalsKanagawa, JapanBiomarkers and Heart Diseases,UMR-942, Institut National de laSanté et de la Recherche Médicale (INSERM)Paris, France
- Tiny Jaarsma PhD RNProfessor in NursingDepartment of Social and Welfare StudiesLinköping UniversityLinköping, Sweden
- Allan S Jaffe FAHA FACC FESCProfessorDepartment of Cardiology and Laboratory Medicine and PathologyMayo Clinic and Medical SchoolRochester, Minnesota, USA
- Brian E Jaski MDMedical Director, Advanced HeartFailure and Cardiac TransplantProgramSharp Memorial HospitalDirector of Clinical ResearchSan Diego Cardiac CenterSan Diego, California, USA
- Corrine Y Jurgens PhD RN ANP FAHA FAANAssociate Professor and Directorof Cardiovascular ResearchSchool of Nursing, Stony BrookUniversityStony Brook, New York, USA
- Matt M Kawahara BAStaff Research AssociateVA San Diego Healthcare SystemSan Diego, California, USA
- Benjamin A Kipper BS MDMedical StudentSchool of MedicineOakland University WilliamBeaumont School of MedicineRochester, Michigan, USA
- David E Krummen MD FACC FHRSAssociate ProfessorDepartment of MedicineUniversity of CaliforniaDirector of ElectrophysiologyVA San Diego Healthcare SystemSan Diego, California, USA
- Vijaya A Kumar MD MPHAssistant ProfessorDepartment of EmergencyMedicine, Wayne State University
- Gautam G Lalani MDPhysicianDepartment of Cardiology and Cardiac ElectrophysiologyKaiser Permanente San DiegoSan Diego, California, USA
- Elizabeth Lee BSResearch CoordinatorMaisel Cardiology Research LabSaratoga, California, USA
- Phillip D Levy MD MPHAssociate Professor of EmergencyMedicineAssistant Director of Clinical Research, Cardiovascular ResearchInstituteAssociate Director of Clinical Research, Department of Emergency MedicineDirector, Clinical Research CenterWayne State University School ofMedicineDetroit, Michigan, USA
- Alexander R Lyon MA BM BCh PhD FRCPBHF Senior Lecturer and HonoraryConsultant CardiologistNIHR Cardiovascular BiomedicalResearch UnitRoyal Brompton and HarefieldNHS Foundation Trust andNational Heart and Lung Institute,Imperial College LondonLondon, England, UK
- Nicholas A Marston MDChief Medical ResidentDepartment of Internal MedicineUniversity of CaliforniaSan Diego, California, USA
- Josep Masip MD PhD FESCDirectorDepartment of Intensive CareDepartment Consorci Sanitari IntegralHeadDepartment of CardiologyHospital Sanitas CIMAAssociate ProfessorDepartment of CardiologyUniversity of BarcelonaBarcelona, Spain
- Patrick McCann MDDirector of Heart Failure and Mechanical Circulatory SupportDepartment of CardiologyPalmetto HealthColumbia, South Carolina, USA
- Alexandre Mebazaa MD PhDProfessorDepartment of Anesthesiologyand Critical Care MedicineBiomarkers and Heart Diseases,UMR-942, Institut National de laSanté et de la Recherche Médicale (INSERM)Department of Anesthesiologyand Intensive CareLariboisière-Saint-Louis University HospitalAssistance Publique–Hôpitaux de Paris, Université ParisDiderot, Paris, France
- Hirsch S Mehta MD FACCAssociate DirectorSan Diego Cardiac Center andSharp Memorial Hospital
- Wouter C Meijers MDProfessorDepartment of CardiologyUniversity Medical CenterGroningenUniversity of GroningenGroningen, Netherlands
- Wayne Miller FAHA FACCProfessorDepartment of CardiologyMayo Clinic and Medical SchoolRochester, Minnesota, USA
- Rajeev C Mohan MDAdvanced Heart Failure andTransplant Cardiology FellowDepartment of CardiologyCedars-Sinai Medical CenterLos Angeles, California, USA
- Andrew C Morley-Smith MB BChir MRCPBHF Clinical Research FellowNIHR Cardiovascular BiomedicalResearch Unit, Royal Brompton and Harefield NHSFoundation Trust and NationalHeart and Lung Institute, ImperialCollege LondonLondon, England, UK
- Silvia Navarin MDResident in Emergency MedicineDepartment of EmergencyMedicine, Sapienza University Sant'Andrea HospitalRome, Italy
- Keshav R Nayak MD FACC FSCAIDirector, Cardiac CathlabsDepartment of CardiologyNaval Medical Center San DiegoSan Diego, California, USA
- Michel Noutsias FESCAssistant Medical DirectorDepartment of CardiologyUniversity Hospital of JenaJena, Thuringia, Germany
- Minal V Patel BScResearch CoordinatorDepartment of Medicine, CardiologyUniversity of California at San DiegoVA San Diego Healthcare SystemSan Diego, California, USA
- John Parissis MDAssociate Professor of CardiologyDepartment of CardiologyAttikon University HospitalAthens, Greece
- W Frank Peacock MD FACEPProfessorDepartment of Emergency MedicineBaylor College of MedicineHouston, Texas, USA
- Kenneth Planas MDStaff PhysicianDepartment of Intensive CareConsorci Sanitari IntegralBarcelona, Spain
- Christian Prinz MD FESCCardiologistPrivate Office for CardiologySögel, Niedersachsen, Germany
- Sonal Sarkariya MDInternal MedicineSt. Joesephs Hospital
- Amir A Schricker MD MS FACCAssistant ProfessorDepartment of MedicineUniversity of CaliforniaSan Diego, California, USA
- Kevin S Shah MDFellow, Department of CardiologyUniversity of CaliforniaLos Angeles, California, USA
- Salvatore Di Somma MD PhDProfessor of MedicineDirector Emergency MedicineChairman Postgraduate School ofEmergency MedicineDepartment of Medical-SurgerySciences and TranslationalMedicine, Sapienza University Sant'Andrea HospitalRome, Italy
- Anna Strömberg PhD RN FAAN NFESCProfessor, Department of Medical and Health SciencesLinköping UniversityLinköping, Sweden
- Wai Hong W Tang MDProfessor of MedicineCardiovascular Medicine, Heartand Vascular InstituteCleveland ClinicCleveland, Ohio, USA
- Rogier Van der Velde MDResidentDepartment of CardiologyIsala KliniekenZwolle, Netherlands
- Joel R Wilson MDAssistant Professor of Medicineand RadiologyDirector, Advanced CardiovascularImagingDepartment of Internal Medicineand RadiologyUniversity of CaliforniaSan Diego, California, USA
- Yang Xue MDCardiologistDepartment of CardiologyKaiser PermanenteHarbor City, California, USA
It is clear to every healthcare practitioner that heart failure has become a worldwide epidemic. The scourge of obesity and heart disease and the aging of the population have certainly contributed to this phenomenon, as has the longer survival following therapeutic interventions for acute myocardial infarction and cardiac disease in general. Thus, with the increasing prevalence of heart failure, it is important to examine the newest data as well as the latest treatment paradigms. Our first book, Heart Failure: The Expert's Approach, provided timely and useful information. This new book, is a shorter, hands-on version, replete with useful algorithms and flowcharts that can be immediately utilized by the practicing physicians.
As in the textbook, Professor Pang from Northwestern University handled section 1 on the emergency department. In this section, we have covered the spectrum of what one would see and do in the emergency. From the early evaluation of the dyspneic patient to the diagnostic techniques, including biomarkers, echocardiography, and impedance to appropriate triage, risk stratification, and treatment of the patient, we offer practical suggestions to simplify diagnosis and management in this urgent care setting.
Section 2 deals with heart failure in the hospital, which includes the use of biomarkers, the latest medical treatments, and the associated comorbidities such as hyponatremia, coronary artery disease, and cardiorenal syndromes.
Section 3 deals with how to take care of chronic heart failure patients in the outpatient setting. There are chapters on monitoring with echocardiography and biomarkers, as well as strategic chapters on preserved ejection fraction, atrial fibrillation, and issues with anticoagulation.
Section 4 deals with special issues in heart failure. This includes, age, gender, sex, and ethnic issues, along with heart failure in other countries as well as the veterans systems. We also deal with heart failure in the nursing home setting and get a good nursing perspective.
Section 5 deals with the approach to end-stage heart failure, and the final section deals with practical recommendations for diagnosis and management of cardiomyopathies.
We hope the readers, whether they be primary care physicians, house officers, practicing cardiologists, or nurses, will both learn and enjoy the contents of this book.
Alan S Maisel
Gerasimos S FilippatosAcknowledgments
I would like to first acknowledge the now deceased Dr Ralph Shabetai, who as my first chief of cardiology gave me his time and advice and turned my interests towards challenges of the heart failure patient. Never have I met a more selfless and giving man than Ralph. Second, I would like to thank my laboratory personnel without whose help and support I would never have been productive. A special thanks to my lab director, Steve Carter, for 25 years of unwavering loyalty. I would like to thank the publishers M/s Jaypee Brothers Medical Publishers (P) Ltd. for being incredibly supportive to this long endeavor, in particular, Dr Neeraj Choudhary for his friendship and advice. Finally, I would be completely remiss if I did not thank my five children who, lost their mother several years ago and on a daily basis remind me of why God put me on earth. And Fran, my lovely wife, thanks for putting up with my long hours, extensive travel, and crazy sense of humor.Acknowledgments
I would like to acknowledge the help and support of my parents Spyridon and Angeliki. Till the end of their life, they were close to me, ready to help in any initiative, any new project that I started. I also owe much to Professor George Baltopoulos, who trained me in critical care and helped me from my first steps in research to my doctoral degree, more than 25 years ago. I am grateful to Professor Lambros Anthopoulos, former Chair of the Department of Cardiology at Evangelismos Hospital, who gave me the opportunity to develop and direct the Heart Failure Unit and the Intensive Cardiac Care Unit at Evangelismos Hospital in the mid-1990s; and to Professor Dimitrios Kremastinos, who asked me 10 years ago to organize and run the Heart Failure Unit at Attikon University Hospital. However, my biggest supporters are my wife Maria and my daughter Angela. It is difficult to make space for a life away from work. This becomes impossible if you are trying to find time to write a book on the top of the other activities. Thank you for your support.