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Low Cardiac Output

Cardiac Output Decreased


Presentation

  • We herein present a unique case of a difficult-to-treat Graves' disease presenting with severe pulmonary hypertension resulting in low cardiac output thyroid storm.[ncbi.nlm.nih.gov]
  • However, this clinical presentation is uncommon, and its management is controversial.[ncbi.nlm.nih.gov]
  • We here present a patient with a history of alcoholic abuse who had suffered hemodynamic deterioration with extremely low cardiac output refractory to extracorporeal membrane oxygenation and intravenous catecholamine support, which was improved dramatically[ncbi.nlm.nih.gov]
  • Hazard ratios and their 95% confidence intervals (CI) are presented. RESULTS: The 5-year mortality was 36.6% (n. 11).[ncbi.nlm.nih.gov]
  • In this case series we present the short-term haemodynamic effects of levosimendan added to dobutamine for the management of low cardiac output syndrome after cardiac surgery.[ncbi.nlm.nih.gov]
Falling
  • Ventricular fibrillation causes cardiac output to fall to zero, and therefore leads to profound hypotension.[cvphysiology.com]
  • Although beating faster helps to maintain cardiac output as the stroke volume falls, a faster heart rate can be counterproductive because it allows less time for the ventricle to fill with blood after each heartbeat.[northshore.org]
  • Fluid is withdrawn until intrapericardial pressure falls below right atrial pressure, usually to subatmospheric levels.[merckmanuals.com]
  • […] ventricle, with subsequent engorgement of the systemic veins, producing pitting edema, enlargement of the liver, and ascites. low-output heart failure Forward failure syndrome, low cardiac output syndrome A clinical condition in which the cardiac output falls[medical-dictionary.thefreedictionary.com]
  • […] remodelling process is a common therapeutic target Neuro-hormonal mechanisms In the early stages of heart failure, these mechanisms help maintain a near normal perfusion to vital organs by increasing systemic vascular resistance as a way to balance the fall[pathophys.org]
Heart Disease
  • Therefore, it is even expectable that congenital heart disease and myocardial infarction will cause the heart to malfunction and pump less amounts of blood per minute.[ic.steadyhealth.com]
  • KEYWORDS: Cardiogenic shock; Congenital heart disease; Heart failure; Intensive care; Neonates; Vasoactive[ncbi.nlm.nih.gov]
  • Abstract In 42 children with congenital heart disease coagulation factor levels were studied serially during the first 20 hours following cardiopulmonary bypass surgery.[jcp.bmj.com]
  • No References No Citations No Supplementary Data No Article Media No Metrics Keywords: Congenital heart diseases ; epoprostenol ; low cardiac output syndrome ; nitric oxide ; pediatric cardiac surgery ; pulmonary hypertension ; sildenafil Document Type[ingentaconnect.com]
  • disease, congenital heart disease, cardiomyopathy, pulmonary disease, arrhythmias, drug effects, fluid overload, decreased fluid volume, and electrolyte imbalance.[nursingcareplan.blogspot.com]
Hypotension
  • A 15-year-old girl with Graves' disease presented with hypotension after methimazole and propranolol were re-started for hyperthyroidism. She was found to have pulmonary artery hypertension resulting in obstructive shock.[ncbi.nlm.nih.gov]
  • Secondary postoperative outcomes investigated included myocardial injury, supraventricular arrhythmias, development of LCOS, acute kidney injury (AKI), duration of mechanical ventilation, intensive care unit and hospital lengths of stay, and incidence of hypotension[ncbi.nlm.nih.gov]
  • Vasodilators are not recommended in those with a systolic BP less than 90 mmHg and a MAP less than 65 mmHg to avoid hypotension and further compromising organ perfusion.[clinicaladvisor.com]
  • Symptoms of decreased cardiac output Although the hypotension is the main symptom of this condition, it can be manifested through numerous other symptoms among which are arrhythmias, dyspnea, decreased peripheral pulses and angina as well as edema, tachypnea[ic.steadyhealth.com]
  • 低心拍出症候群 低心拍出量 低心拍出量症候群 低拍出症候群 低拍出量 概念ツリー: 循環器疾患 cardiovascular disease 心疾患 heart disease 心拍出量低下 low cardiac output 病的状態と徴候・症状 pathological condition, sign and symptom 徴候と症状 signs and symptoms 心拍出量低下 low cardiac output 関連語: 心拍出量 ( cardiac output ) 低血圧 ( hypotension[lsd-project.jp]
Confusion
  • Furthermore, people with decreased heart output may also experience orthopnea, weight gain, dizziness and confusion. Anxiety, weakness and tiredness are also some of the symptoms that can appear when this heart disorder is in the question.[ic.steadyhealth.com]
  • Restlessness is noted in the early stages; severe anxiety and confusion are seen in later stages. * Assess heart rate and blood pressure.[nursingcareplan.blogspot.com]
  • Clinical features of the condition Fatigue, confusion, agitation and/or decreased level of consciousness Cool peripheries, mottled peripheries and delayed capillary refill time Hypotension Tachycardia or bradycardia Thready pulse Raised jugular venous[clinicaladvisor.com]
  • Confusion and/or impaired memory Manifestations of inadequate cerebral blood supply Decreased urine output Decreased renal perfusion during the daytime can sometimes lead to acute kidney injury and eventually renal failure.[pathophys.org]
Dizziness
  • Furthermore, people with decreased heart output may also experience orthopnea, weight gain, dizziness and confusion. Anxiety, weakness and tiredness are also some of the symptoms that can appear when this heart disorder is in the question.[ic.steadyhealth.com]
  • [SVO2], cardiac output) * Arrhythmias, electrocardiogram (ECG) changes * Rales, tachypnea, dyspnea, orthopnea, cough, abnormal arterial blood gases (ABGs), frothy sputum * Weight gain, edema, decreased urine output * Anxiety, restlessness * Syncope, dizziness[nursingcareplan.blogspot.com]
  • Acute decrease of blood pressure can result in the shock syndrome, whereas long-term reduction leads to lethargy, fatigue, weakness, dizziness, fainting and other symptoms.[news-medical.net]

Workup

  • MEASUREMENTS AND MAIN RESULTS: Clinical and echocardiographic assessment of hemodynamics was performed within 48 hours of sepsis workup and repeated at least 24 hours later.[ncbi.nlm.nih.gov]
  • An echocardiogram and an electrocardiogram are standard in the workup of dyspnea that may be due to cardiac disease.[clevelandclinicmeded.com]
Lactate Decreased
  • Six hours after calcium initiation, A-V oxygen saturation difference decreased by 7.4 % (32.6 2.1 to 25.2 2.0 %, p 0.001), rSO2 increased by 5.5 % (63.1 vs 68.6 %, p 0.001), and serum lactate decreased by 0.9 mmol/l (3.3 vs 2.4 mmol/l, p 0.001) with no[ncbi.nlm.nih.gov]

Treatment

  • Milrinone, epinephrine, dopamine and dobutamine are mostly used, and should be prioritised for future research on LCOS treatment.[ncbi.nlm.nih.gov]
  • Echocardiographic, Doppler-derived, time interval-based index of myocardial performance (Tei index) was used to study cardiac function prior to and while on intravenous milrinone treatment for 18-24 hours.[ncbi.nlm.nih.gov]
  • Three trials with high overall risk of bias compared levosimendan to standard treatment (enoximone or dobutamine) or placebo.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Perioperative treatment with GIK was associated with a significant reduction in the incidence of low cardiac output state and the need for inotropic support.[ncbi.nlm.nih.gov]
  • OBJECTIVE: Extracorporeal life support (ECLS) is a widely accepted modality for the treatment of postoperative low cardiac output syndrome (LCOS) after major cardiac surgery by providing temporary circulatory support for the stunned myocardium.[ncbi.nlm.nih.gov]

Prognosis

  • […] considerably high P-AVP (5.9 6.1 pg/ml) negatively correlated with serum sodium concentration (S-Na, 135.3 5.8 mEq/L, r -0.548 [P CONCLUSIONS: Low cardiac output stimulates AVP release via a non-osmotic process that results in hyponatremia and poor prognosis[ncbi.nlm.nih.gov]
  • Additionally, Chagas disease patients have higher B type natriuretic peptide levels and a worse prognosis independent of lower ejection fraction.[ncbi.nlm.nih.gov]
  • Abstract Liver dysfunction due to a low cardiac output state after cardiac surgery is associated with a poor prognosis, but whether one inotrope is superior to another in improving hepatic perfusion remains uncertain.[ncbi.nlm.nih.gov]
  • Multicenter studies and late follow-up will determine whether routine use of GIK improves patient prognosis.[ncbi.nlm.nih.gov]
  • Other parameters may be more important than MELD score to predict prognosis.[gut.bmj.com]

Etiology

  • BACKGROUND: The etiology of chronic fatigue syndrome (CFS) is unknown. Orthostatic intolerance (OI) is common in CFS patients. Recently, small heart with low cardiac output has been postulated to be related to the genesis of both CFS and OI.[ncbi.nlm.nih.gov]
  • This article provides an overview of the determinants involved in oxygen transport, the physiologic factors influencing cardiovascular function, the assessment of hemodynamic variables, the etiology of LCOS, and management strategies, including a brief[ncbi.nlm.nih.gov]
  • Depending on etiological factors, common medications include digitalis therapy, diuretics, vasodilator therapy, antidysrhythmics, ACE inhibitors, and inotropic agents. * Maintain optimal fluid balance.[nursingcareplan.blogspot.com]
  • Needle pericardiocentesis is often best when the etiology is known or the presence of tamponade is in question. Surgical drainage is best when the presence of tamponade is certain but the etiology is unclear.[merckmanuals.com]
  • Etiology of low cardiac states by pathophysiological category Table IV.[clinicaladvisor.com]

Epidemiology

  • […] konstantin.averin@cchmc.org. 2 The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA. 3 The Heart Center, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA. 4 Division of Biostatistics and Epidemiology[ncbi.nlm.nih.gov]
  • Epidemiology The prevalence of the ‘low cardiac output state’ is difficult to define.[clinicaladvisor.com]
Sex distribution
Age distribution

Pathophysiology

  • Etiology of low cardiac states by pathophysiological category Table IV.[clinicaladvisor.com]
  • Many overlapping mechanisms account for descriptive terms used in the medical literature, such as "air hunger," "chest tightness," and many others. 1 Pathophysiology The mechanisms and pathophysiology of dyspnea involve interactions between the respiratory[clevelandclinicmeded.com]
  • To understand more fully the physiology and pathophysiology of hypotension, see the Blood Pressure Regulation Tutorial.[cvphysiology.com]
  • Lilly, Pathophysiology of Heart Disease, 2007 Predominantly systolic dysfunction is seen in a majority of patients, while others exhibit mainly diastolic dysfunction . Components of both can also be found.[pathophys.org]

Prevention

  • Nursing goals, in response to hypovolemia, are to increase the circulating volume, optimize oxygen delivery, stabilize hemodynamics, improve tissue perfusion, and prevent shock.[ncbi.nlm.nih.gov]
  • Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved.[ingentaconnect.com]
  • It helps to prevent pulmonary congestion and its associated pulmonary hemorrhage.[thieme-connect.com]
  • See Arteriosclerosis - what causes it and how to prevent it. Poor conversion of fuel and oxygen into ATP ie mitochondrial failure. See CFS - The Central Cause: Mitochondrial Failure. Not enough blood in circulation. See Anaemia.[drmyhill.co.uk]
  • Is It Possible to Prevent Cardiomyopathy? Cardiomyopathy is a term that describes the end result of many diseases and illnesses.[emedicinehealth.com]

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