Manual of Cardiac Intensive Care

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Common Misconceptions ■ Left ventricular recovery is common after placement of left ventricular assist devices (LVAD). ■ Patients who are candidates for heart transplantation should never have an LVAD placed. ■ Palliative care consultation is inappropriate for patients being considered…

Common Misconceptions ■ An intraaortic balloon pump should be placed in all patients with acute myocardial infarction complicated by shock. ■ Impella has been demonstrated in randomized controlled trials to improve survival in cardiogenic shock. ■ Impella has been demonstrated…

Common Misconceptions ■ Invasive hemodynamic monitoring should be used in all patients in the Cardiac Intensive Care Unit (CICU). ■ The pulmonary capillary wedge pressure is always a surrogate for left ventricular end-diastolic pressure. ■ Mixed venous oxygen saturation can…

Common Misconceptions ■ Pericardial tamponade is an echocardiographic diagnosis. ■ Large, stable pericardial chronic effusions will not progress to cardiac tamponade. ■ Size is the critical factor in determining the hemodynamic effects of a pericardial effusion. You’re Reading a Preview…

Common Misconceptions ■ The indication for a pacemaker is solely based on the patient’s heart rate. ■ Transcutaneous pacing may be performed on conscious patients without sedation. ■ A temporary transvenous pacemaker may be placed from the femoral vein without…

Common Misconceptions ■ The Allen test allows accurate assessment of the arterial blood supply of the hand. ■ Dark blood color and the absence of pulsatility are sufficient to confirm venous access. ■ The absence of a femoral hematoma rules…

Common Misconceptions ■ Lidocaine is used to prevent ventricular tachycardia following acute myocardial infarction. ■ Only β-blockers with β 2 selectivity precipitate bronchospasm. ■ Amiodarone should be avoided in patients with left ventricular dysfunction. ■ Cardiac arrhythmias are common in…

Common Misconceptions ■ The same diuretic doses should work for most patients regardless of renal function. ■ All patients with pulmonary edema and peripheral edema are volume overloaded. ■ Continuous infusion of loop diuretics is no more effective than intermittent…

Common Misconceptions ■ Pulmonary artery catheterization plays no role in the evaluation and treatment of patients in the Cardiac Intensive Care Unit (CICU). ■ Dobutamine is an appropriate treatment of hypotension, regardless of etiology. ■ Milrinone is not used in…