when i first met this nice lady, i was in an evening work shift of ccu. this 69 years-old woman had been referred recently to our ward. she had a pale and puffy face. she suffered from chf. she had a normal breathing, but her ankle was swollen.   we stabilized her condition easily but, it was just the first step in her treatment way. prevention of recurrence of heart attack was our goal. every ...

Both acute and chronic pain are common coexisting problems in patients with heart failure. Because nonsteroidal anti-inflammatory drugs and corticosteroids are contraindicated in heart failure, traditional pain management algorithms require modification. This article reviews pertinent pain management principles, including pain vocabulary, barriers to pain management, and general pain assessment...

BACKGROUND Type 2 diabetes is an important risk factor for heart failure and is common among patients with heart failure. The impact of weight on prognosis after hospitalization for acute heart failure among patients with diabetes is unknown. The objective of this study was to examine all-cause mortality in relation to weight status among patients with type 2 diabetes hospitalized for decompens...

n-terminal pro β-type natriuretic peptide (nt-probnp) is a valuable marker for monitoring the response to treatment in patients with heart failure. based on the clinically observed improvement of heart failure symptoms early after cardiac resynchronization therapy (crt), we sought to investigate whether crt induce any significant reduction in the plasma level of nt-probnp in three days after im...

Hemodynamic monitoring has moved in the last few years from being the holy grail of evaluating patients with acute heart failure to being all but extinct. Recent studies have not demonstrated any sustained benefits from right heart catheterization, and some studies have even suggested harm due to adverse events related to this invasive procedure. It is possible that this lack of efficacy is rel...

The presence of heart failure or LV systolic dysfunction in the setting of acute myocardial infarction is associated with poor prognosis. Aldosterone is an important downstream mediator of the renin-angiotensin-aldosterone system which, in the post-acute myocardial infarction setting, promotes myocardial collagen deposition, myocardial fibrosis, apoptosis, endothelial dysfunction, ventricular r...

BACKGROUND In a canine model of congestive heart failure beta endorphin concentrations were high and opioid receptor antagonists exerted beneficial haemodynamic effects. In humans previous studies have suggested that opioid peptides may modify the perception of breathlessness and fatigue in heart failure. METHODS Plasma concentrations of beta endorphin were measured in patients with acute and...

Heart failure is an emerging epidemic owing to the growing and ageing population. As such, novel educational programmes for physicians develop professional competence in all aspects of care patients with acute and/or chronic heart are needed.