Lisa J. Rose-Jones, John buy STI571 J. Rommel, and Patricia P. Chang Heart failure

with preserved ejection fraction (HFpEF) is a complex clinical syndrome based on traditional heart failure symptoms with documentation of increased left ventricular filling pressures and preserved left ventricular ejection fraction. The exact mechanisms that induce HFpEF are not known. End-diastolic ventricular stiffness does not seem to be acting alone. Substantial mortality exists compared with healthy age-matched controls, as well as significant health care expenditures on hospitalizations and readmissions. This article reviews the epidemiology, pathophysiology, and treatment of heart failure with preserved ejection fraction (HFpEF). Current practice guidelines focus on remedying volume overload, aggressively controlling hypertension, and treatment of comorbid conditions that contribute to decompensation.

Scott Feitell, Shelley R. Hankins, and Howard J. Eisen Heart failure is a costly and difficult disease to treat. However, new metrics make it an imperative to keep these patients out of the hospital. Implementing and maintaining patients on successful treatment plans is difficult. A multitude of factors make transitioning care to the outpatient selleck compound setting difficult. A careful and well-orchestrated team of cardiologists, general practitioners, nurses, and ancillary support staff can make an important difference to patient care. A strong body of literature supports the use of pharmacologic therapy, and evidence-based therapies can improve mortality and quality of life, and reduce hospital admissions. Adjunctive therapies can be equally important. Index 175 “
“Umesh K. Gidwani, Samin K. Sharma, and Annapoorna S. Kini Umesh K. Gidwani and Annapoorna S. Kini This article presents an overview of the evolution of cardiac critical care in the past half century. It tracks the rapid advances in the management of cardiovascular disease and how the intensive care area has almost kept pace,

improving outcomes and incorporating successive innovations. The current multidisciplinary, evidence-based unit is vastly different from the early days and is expected to evolve further in keeping with the concept of “hybrid” care areas where care is delivered by the “heart team”. Jack Z. Li, Kim A. Eagle, and Prashant Vaishnava Acute aortic syndromes are among the most lethal of the cardiovascular diseases. Delays in recognition, diagnosis, and treatment are associated with increases in mortality. Signs and symptoms are sometimes subtle and atypical, and a high index of suspicion is useful to guide the diagnostic evaluation. Uncontrolled hypertension remains the most significant treatable risk factor. Immediate management involves blood pressure reduction. β-Blockers are the first drugs of choice.