Dr Dimitrios presents an insightful case study and looks at the rationale for the patient’s course of treatment in the CCU, on ward and at discharge. A particular focus is given to the pleiotropic effects of levosimendan and its unique triple mechanism of action which is an advantage in treating AHF due to ACS.
In AdHF and AHF, hospitalisations for worsening symptoms are significant predictors of increased mortality. Can a window of opportunity be harnessed to avert haemodynamic deterioration? Is intermittent levosimendan a viable option to avoid rehospitalisation?
Professor von Lewinski discusses why cardiac index and frequency are key features in heart failure. What differences are there in preload and afterload in a normal heart compared to a failing heart and what can be done to overcome this?
Professor John Parissis presents a classical case study of acute hypertensive pulmonary oedema with history of COPD, and also a patient with low output syndrome and worsening renal function. What suggestions are there for preferred inotropes in different clinical settings?
Although AdHF syndrome is now well defined and characterised, guideline-directed therapy is by definition inadequate. Dr Yerly explains when heart transplantation, left ventricular assist device (LVAD), or use of inotropes should be considered and why.