Pearls from Dr. Reshad Garan

76 y/o with acute decompensated HF 2/2 Fulminant Myocarditis


    1. **Normal coronaries do NOT r/o MI - can have embolic event that lyses**
    2. Pt. with Enterovirus and HF symptoms - think about Myocarditi

    Posted 08/09/16 10:46:45 AM by Adam Faye

  • Acute Fulminant Myocarditis - typically have normal ventricular size - large dilated ventricles more characteristic of a chronic picture.
    TTE with Definity - Ultrasound contrast agent that can opacify the LV and improve delineation of the LV endocardial border (see thrombus)
    Myocarditis with electrical abnormalities- think about Giant Cell Myocarditis

    Posted 08/09/16 10:47:58 AM by Adam Faye

  • IABP (Intra-aortic balloon pump) - 1/2 - 1L augmentation (need pulsatility) --> good for decompensated HF in chronic patients (in chronic HF patients- typically compensated - so small augmentation will help; whereas those with acute HF need more augmentation of flow).
    When patient on multiple inotropes start to think of circulatory support.

    Posted 08/09/16 10:57:57 AM by Adam Faye

  • Intermacs Profile Clinical picture of a patient going for a VAD.

    Posted 08/09/16 11:00:08 AM by Adam Faye

  • VA ECMO - Increases afterload for a failing ventricle so can worsen recovery -> can also lead to atrial valve closure/thromus formation

    Posted 08/09/16 03:00:00 PM by Adam Faye

  • For further reading...


    Posted 08/09/16 03:16:29 PM by Adam Faye

  • Created by Christopher Kelly
    Book be65e564ffbc09cd3ee32372501a5ece813f14b576dc711ff66870a4906e7f62
    Know a hypochondriac? Get them the best-selling book 'AM I DYING?!: A Complete Guide to Your Symptoms, and What to Do Next'
    The information on the website does not constitute official guidelines except where explicitly stated.
    It is not meant to replace the advice of a health professional.