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Left Ventricular Assist Device (LVAD) Patient Decision Aid Page showing options, presenting probabilities, using statistics, and highlighting uncertainty. Because the majority of people without a left ventricular assist device (LVAD) die imminently, this option required unique framing regarding benefits, risks, and burdens. We presented the LVAD (accepting) and no LVAD (declining) in a column format (Figure 3). The parallel contrast between the 2 options helped emphasize that DT LVAD is a choice. This reframing was important given the tendency of patients and caregivers to describe the LVAD as a Hobson’s choice, that is, a choice between something and nothing. The parallel framing concretely showed what the no-LVAD option might look like to facilitate viewing the situation as a dilemma, that is, a choice between 2 imperfect options. However, because patients who decline a DT LVAD have such a high mortality rate, presenting the risks and benefits of LVAD declination in a substantive way was a challenge. #DecisionAid #DTLVAD #LVAD #VentricularAssistDevice #Management #CHF #Cardiology

General Algorithms for Assessment of the Left Ventricular Assist Device (LVAD) (Algorithms 1, 2 and 3) Algorithm 1: Initial Assessment of the Left Ventricular Assist Device (LVAD) Patient Algorithm 2: LVAD troubleshooting Algorithm 3: Ensuring adequate circulation to sustain life #Diagnosis #LVAD #Assessment #Evaluation #VentricularAssistDevice #Algorithm #Management #BMJ

Primary and Secondary Causes of Cardiomyopathy (a) Primary cardiomyopathies - Genetic - Mixed (genetic/acquired) - Acquired (b) Secondary cardiomyopathies - Infiltrative* - Storage* - Toxicity - Endomyocardial - Inflammatory (granulomatous) - Endocrine - Cardiofacial - Neuromuscular/neurological - Nutritional deficiencies - Autoimmune/collagen - Electrolyte imbalance - Consequences of cancer therapy #Diagnosis #Cardiology #NonIschemic #Primary #Secondary #Cardiomyopathy #Differential #Causes

Atrial Fibrillation - Rate Control and Rhythm Control - Management Infographic by Dr. Pouria Rezapour @prezapour #Atrial #Fibrillation #AFib #RateControl #RhythmControl #Cardioversion #Emergency #Cardiology #Indications #Management

Flowchart to diuretic use in acute heart failure. (A) Congestion with volume overload. (B) Treatment algorithm after 24 h. Total loop diuretic dose can be administered either as continuous infusion or bolus infusion. BP, blood pressure; HF, heart failure; IV, intravenous; SGLT2‐I, sodium–glucose linked transporter 2 inhibitor; UF, ultrafiltration; UO, urine output. &Higher dose should be considered in patients with reduced glomerular filtration rate. *Consider other reasons for dyspnoea given the quick resolution of congestion. °The maximal dose for IV loop diuretics is generally considered furosemide 400–600 mg or 10–15 mg bumetanide. #In patients with good diuresis following a single loop diuretic administration, once a day dosing can be considered. #Diuretic #Diuresis #CHF #Algorithm #Congestive #HeartFailure #Cardiology #Management

The distinctive phenotypes of Acute Decompensated Heart Failure (ADHF), their presentations, and suggested therapeutic routes #Phenotypes #HeartFailure #Decompensated #CHF #Diagnosis #Management #Presentations

In order to better classify heart failure, the American College of Cardiology Foundation and the American Heart Association in 2001 published a four-component staging of heart failure in which progression occurs in only one direction using risk factors as a classification model. The previous New York Heart Association functional class, based solely on symptoms, can still describe the current functional status of a patient in Stages B through D of the ACC/AHA Classification. But now the ACC/AHA classification allows for categorization of patients as their status changes by improving or becoming worse, especially in Stage C. Below one can see how these two classification methods crossover and classify a patient. With treatment, a heart failure patient can become asymptomatic, but will remain Stage C. Stage B is defined as development of structural heart disease in patients who never show symptoms or signs of heart failure. Most patients with a diagnosis of heart failure with either past or current symptoms are considered Stage C. Approximately 1% of patients with heart failure have progressed to an advanced Stage D. #Diagnosis #Cardiology #CHF #Congestive #HeartFailure #Staging #Classification #Stages #Classes #NYHA #ACCAHA

Traditionally, congestive heart failure has been classified according to severity of symptoms, first formulated by the New York Heart Association, which is classes I-IV. STAGES of CHF (A, B, C, D), however, describe the severity of structural abnormalities that impair the ability of the cardiovascular system to circulate blood. Stage D CHF is frequently associated with end-stage heart failure, although there are sometimes advanced treatment options that may help prolong life and decrease frequency of hospitalization arising from flare ups that cause class III and class IV symptoms. #Diagnosis #Cardiology #CHF #Congestive #HeartFailure #Staging #Classification #Stages #Classes #NYHA #ACCAHA

Stages in the development of HF and recommended therapy by stage. ACEI indicates angiotensin-converting enzyme inhibitor; AF, atrial fibrillation; ARB, angiotensin-receptor blocker; CAD, coronary artery disease; CRT, cardiac resynchronization therapy; DM, diabetes mellitus; EF, ejection fraction; GDMT, guideline-directed medical therapy; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; HRQOL, health-related quality of life; HTN, hypertension; ICD, implantable cardioverter-defibrillator; LV, left ventricular; LVH, left ventricular hypertrophy; MCS, mechanical circulatory support; and MI, myocardial infarction. #CHF #Congestive #HeartFailure #Staging #Stages #ACCAHA #Algorithm #Management #Cardiology