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BJA Advance Access originally published online on May 14, 2004
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British Journal of Anaesthesia, 2004, Vol. 93, No. 1 74-85
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Heart failure

J. J. Magner and D. Royston*

Department of Anaesthesia and Intensive Care Medicine, Royal Brompton and Harefield NHS Trust, Harefield Hospital, Harefield, Middlesex, UB9 6JH, UK.

*Corresponding author. E-mail: dave@tharg.demon.co.uk

Keywords: complications, heart, failure; equipment, assist devices; treatment

The first 150 words of the full text of this article appear below.

Congestive heart failure is a complex clinical syndrome characterized by impaired ventricular performance, exercise intolerance, a high incidence of ventricular arrhythmias and shortened life expectancy. Congestive heart failure is common and is estimated to affect five million people in the US, 300 000 of whom die per year.34 Hospitalizations and mortality from heart failure have increased steadily since 1968, despite the overall improvement in mortality from cardiovascular disease. Among adults over 65 yr of age, heart failure is the commonest reason for admission to a hospital.11

Heart failure may occur suddenly or develop gradually and is the final common pathway of a variety of primary cardiovascular disease entities. Coronary artery disease and hypertension are the two major risk factors for the development of heart failure in the elderly. Other common aetiologies include diabetes mellitus, valvular heart disease, especially aortic stenosis and mitral regurgitation, and non-ischaemic myopathies.8 It is often multifactorial, . . . [Full Text of this Article]

Pathophysiology of heart failure

Diagnosis

Management

Anaesthetic implications for patients with impaired ventricular function or stage-C heart failure
Interventions with grade-D heart failure
Pharmacological interventions
Inotropy
Reduced preload
Non-pharmacological interventions in heart failure
Synchronized pacing
Surgical ventricular restoration
Mechanical assistance
Choice of device
Summary


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