The Modern Aspects of Acute Heart Failure Management

Acute heart failure (AHF) is one the most common causes of morbidity and mortality. The prognosis of patients admitted with AHF remains dismal, with over 20% experiencing recurrent HF admission and over 20% dying during the first year after initial admission.The purpose of this study was to provide contemporary perspective for hospital management of AHF within the context of the most recent data and to provide guidance, based on expert opinions, to practicing physicians and other healthcare professionals. Material and methods: In this paper we reviewed of current updated European Cardiology Society (ESC) HF guideline (2016) and modern trials for AHF from Medscape database. Results: Diuretics are the main medications in the treatment of patients with AHF and signs of fluid overload and congestion. Intravenous vasodilators are the second most used agent in AHF. Their use was shown to be associated with lower mortality, and a delay in administration was associated with a higher mortality.Use of an inotropic medications (such as dopamine, dobutamine, milrinone, levosimendan, epinephrine, norepenephrine) should be reserved for patients with a severe reduction in cardiac output resulting in compromised vital organ perfusion, which occurs most often in hypotensive AHF. Conclusion: Acute heart failure is a life-threatening medical condition, which needs emergency management for death prevention

Iodine-induced thyroid disorders in the practice of a cardiologist

This article deals with the question of the influence of preparations that contain pharmacological doses of iodine on the functional activity of the thyroid gland. In the practice of a cardiologist amiodarone and x-ray contrasting substances are often used that may induce thyroid disorders in many ways, followed by hypothyroidism and thyrotoxicosis development

THE ISSUE OF AGGRESSION IN PATIENTS WITH VENTRICULAR TACHYCARDIA WITH PULSE AND A SHORT EPISODE OF CARDIAC ARREST — A CASE OF A 68-YEAR-OLD MALE

   INTRODUCTION: Ventricular tachycardia (VT) is a life-threatening event. The role of the medical rescue team is to diagnose this disorder on the basis of resuscitation guidelines and general recommendations concern­ing ECG diagnoses. Patients with ventricular tachycardia, as a result of cerebral hypoxia, may react with aggression. In such situations, taking one’s medical history, conducting a physical examination or attempting emergency rescue operations may become difficult, or even impossible. OBJECTIVE: The objective of the paper is to demonstrate the issue of unintentional aggression that may occur in patients with ventricular tachycardia (VT) with a high heart rate and a short episode of cardiac arrest (CA), and the impact of such a disorder on attempted medical rescue operations. MATERIAL AND METHODS: The analysis of the case study was performed on the basis of medical documen­tation, i.e. an emergency dispatch order and an emergency medical services form. CASE DESCRIPTION: A medical emergency unit stationed at one of the substations in Łódź Province, 27 km away from a multi-disciplinary hospital, received a call from a medical dispatcher. The person calling emer­gency services requested the urgent arrival of an ambulance for her husband, who had suddenly passed out and was now lying on the kitchen floor showing no signs of life. In the course of the ambulance’s arrival at the location, the patient’s wife urged the ambulance to arrive soon, on account of her husband’s aggres­sive behaviour. CONCLUSIONS: Cardiac dysrhythmia and particularly ventricular tachycardia (VT) may constitute a serious health issue for the patient. The clinical picture may also vary across patients. An analysis of the case study demonstrates that medical personnel must be prepared to handle unconventional scenarios. The article shows that the procedure of cardioversion may be the only right choice when handling a patient with an unstable tachycardia