Acute Heart Failure

Question 1

IABP Timing Errors

Answer 1

Question 2

IABP Timing Errors

Answer 2

Question 3

IABP Timing Errors

Answer 3

Question 4

IABP Timing Errors

Answer 4

Question 5

Contraindications to IABP?

Answer 5

Question 6

IABP Indications for use?

Answer 6

Question 7

After IABP is Placed:

1. Cardiac Output
2. PCWP
3. Effective in two particular conditions
4. Best survival after IABP is when?

Answer 7

Question 8

After an IABP is placed?

1. CO
2. Myocardial O2 consumption
3. Aortic pressures
4. SVR (afterload)
5. Coronary blood flow
6. LVEDP

Answer 8

Question 9

Risk factors for low cardiac output syndrome?

Answer 9

Question 10

Temporary mechanical support patient selection?

Answer 10

Question 11

INTERMACS Profile

Life-threatening hypotension despite rapidly escalating inotropic support; critical organ hypoperfusion; often confirmed by worsening acidosis and/or lactate levels (“crash and burn”).

Answer 11

Profile 1: Critical cardiogenic shock

Question 12

INTERMACS Profile

Declining function despite IV inotropic support; may manifest by worsening renal function; nutritional depletion; inability to restore volume balance (“sliding on inotropes”). Also describes declining status in patients unable to tolerate inotropic therapy.

Answer 12

Profile 2: Progressive decline

Question 13

INTERMACS Profile

Stable blood pressure, organ function, nutrition, and symptoms with continuous IV inotropic support (or a temporary circulatory support device or both), but patient demonstrates repeated inability to wean from support due to recurrent symptomatic hypotension or renal dysfunction (“dependent stability”).

Answer 13

Profile 3: Stable but inotrope dependent

Question 14

INTERMACS Profile

Stabilized close to normal volume status but daily symptoms of congestion at rest or during activities of daily living. Doses of diuretics generally fluctuate at very high levels. More intensive management and surveillance strategies should be considered, which may in some cases reveal poor compliance that would compromise outcomes with any therapy.

Answer 14

Profile 4: Resting symptoms

Question 15

INTERMACS Profile

Patient is comfortable at rest and with activities of daily living but unable to engage in any other activity and lives predominantly within the house. Patient is comfortable at rest without congestive symptoms but may have underlying refractory elevated volume status, often with renal dysfunction. If underlying nutritional status and organ function are marginal, patient may be more at risk than INTERMACS Profile 4 and require definitive intervention.

Answer 15

Profile 5: Exertion intolerant

Question 16

INTERMACS Profile

Patient without evidence of fluid overload is comfortable at rest and with activities of daily living and minor activities outside the home, but experiences fatigue after the first few minutes of any meaningful activity. Attribution to cardiac limitation requires careful measurement of peak oxygen consumption, in some cases with hemodynamic monitoring to confirm severity of cardiac impairment.

Answer 16

Profile 6: Exertion is limited

Question 17

INTERMACS Profile

Patient had no current or recent episodes of unstable fluid balance and is living comfortably with meaningful activity limited to mild physical exertion.

Answer 17

Profile 7: Advanced New York Heart Association functional class III

Question 18

UNOS Heart Transplant Statuses

Status 1 Criteria

Answer 18

Question 19

UNOS Heart Transplant Statuses

Status two criteria

Answer 19

Question 20

UNOS Heart Transplant Statuses

Status 3 criteria

Answer 20

Question 21

UNOS Heart Transplant Statuses

Status 4 Criteria

Answer 21

Question 22

UNOS Heart Transplant Statuses

Status 5 Criteria

Answer 22

Question 23

UNOS Heart Transplant Statuses

Status 6 Criteria

Answer 23