What do doctors call this condition?
What is this condition?
Pump failure is a condition of diminished cardiac output that severely impairs the delivery of oxygen and vital nutrients to the body's organs and tissues. It reflects severe failure of the left ventricle, the heart's main chamber, and occurs as a serious complication in nearly 15% of all people hospitalized with a heart attack
Pump failure typically strikes people in whom a heart attack has damaged more than 40% of the heart. The death rate may exceed 85%. Most people with pump failure die within 24 hours of onset. The prognosis for those who survive is poor.
What causes it?
Pump failure can result from any condition that causes significant left ventricular dysfunction with reduced cardiac output, such as a heart attack (most common), myocardial ischemia, papillary muscle dysfunction, or end-stage cardiomyopathy.
Dysfunction of the heart's left ventricle sets into motion a series of compensatory mechanisms that attempt to increase cardiac output and, in turn, maintain vital organ function. These compensatory responses initially stabilize the person but later cause deterioration with the rising oxygen demands of the already compromised heart.
What are its symptoms?
Signs of pump failure are caused by poor perfusion of blood throughout tissues: cold, pale, clammy skin; a drop in blood pressure; rapid heart rate; rapid, shallow breathing; low urine output; restlessness and mental confusion; narrowing pulse pressure; and bluish skin discoloration.
How is it diagnosed?
The doctor listens to the heart for abnormal rhythms, faint heart sounds, and possibly, if the shock is caused by rupture of the ventricular septum or papillary muscles, a murmur. Other abnormal test findings include the following:
. Pulmonary artery pressure monitoring shows changes in pressures within the vessels of the heart and lungs.
. Invasive arterial pressure monitoring shows low blood pressure due to impaired ventricular ejection.
. Arterial blood gas analysis may show metabolic acidosis and hypoxia.
. Electrocardiography may reveal evidence of an acute heart attack, ischemia, or ventricular aneurysm.
. Enzyme studies may provide evidence of a heart attack or ischemia and suggest heart failure or shock.
How is it treated?
The aim of treatment is to enhance the heart's ability to function by increasing its output, improving heart muscle perfusion, and reducing the heart's workload with combinations of various drugs and mechanical-assist techniques. Drug therapy may include Intropin, Inocor or Dobutrex, Adrenalin, and Nitropress.
In some instances, the heart may be helped by an intra-aortic balloon pump. This surgically implanted device consists of a balloon attached to a large-diameter catheter and a pump that approximates the action of the heart in response to a signal from the electrocardiograph machine. It inflates during ventricular diastole to increase coronary artery perfusion, and deflates before systole, to reduce aortic pressure and resistance to ventricular flow. The end result is decreased ventricular workload.
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