Congestive heart failure cardiac catheterization

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Medical Therapy:

Summary
Acute Pharmacotherapy
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Chronic Pharmacotherapy in HFrEF
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Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
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Left Ventricular Assist Devices (LVADs)
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ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Cardiac Catheterization

Coronary Angiography

Coronary angiography is perfomred in patients with heart failure in whom there is a suspicion of underlying atherosclerosis as the basis for the heart failure. Patients who are troponin or CK-MB positive, who have dynamic EKG changes or other signs and symptoms of an acute coronary syndrome who are revascularization candidates should undergo coronary angiography.

Hemodynamic Assessment

Right Heart Catheterization

Right heart catheterization can be useful to assess the following:

Left Heart Catheterization

Left heart catheterization can be useful to assess the following:

2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT) [1][2]

Cardiac Catheterization in Patients Presenting With Heart Failure (DO NOT EDIT) [1][2]

Class I
"1. Coronary arteriography should be performed in patients presenting with heart failure who have angina or significant ischemia unless the patient is not eligible for revascularization of any kind.[3][4][5][6][7] (Level of Evidence: B) "
Class IIa
"1. Coronary arteriography is reasonable for patients presenting with heart failure who have chest pain that may or may not be of cardiac origin who have not had evaluation of their coronary anatomy and who have no contraindications to coronary revascularization. (Level of Evidence: C) "
"2. Coronary arteriography is reasonable for patients presenting with heart failure who have known or suspected coronary artery disease but who do not have angina unless the patient is not eligible for revascularization of any kind. (Level of Evidence: C) "

Vote on and Suggest Revisions to the Current Guidelines

External Links

References

  1. 1.0 1.1 1.2 Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202
  2. 2.0 2.1 2.2 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967
  3. Alderman EL, Fisher LD, Litwin P, Kaiser GC, Myers WO, Maynard C, Levine F, Schloss M (1983). "Results of coronary artery surgery in patients with poor left ventricular function (CASS)". Circulation. 68 (4): 785–95. PMID 6352078. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  4. Eagle KA, Guyton RA, Davidoff R, Edwards FH, Ewy GA, Gardner TJ, Hart JC, Herrmann HC, Hillis LD, Hutter AM, Lytle BW, Marlow RA, Nugent WC, Orszulak TA (2004). "ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery)". Circulation. 110 (14): e340–437. PMID 15466654. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  5. Fox KF, Cowie MR, Wood DA, Coats AJ, Gibbs JS, Underwood SR, Turner RM, Poole-Wilson PA, Davies SW, Sutton GC (2001). "Coronary artery disease as the cause of incident heart failure in the population". European Heart Journal. 22 (3): 228–36. doi:10.1053/euhj.2000.2289. PMID 11161934. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  6. Arques S, Ambrosi P, Gelisse R, Roux E, Lambert M, Habib G (2004). "Prevalence of angiographic coronary artery disease in patients hospitalized for acute diastolic heart failure without clinical and electrocardiographic evidence of myocardial ischemia on admission". The American Journal of Cardiology. 94 (1): 133–5. doi:10.1016/j.amjcard.2004.03.046. PMID 15219526. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  7. Kurtz CE, Gerber Y, Weston SA, Redfield MM, Jacobsen SJ, Roger VL (2006). "Use of ejection fraction tests and coronary angiography in patients with heart failure". Mayo Clinic Proceedings. Mayo Clinic. 81 (7): 906–13. doi:10.4065/81.7.906. PMID 16835970. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)

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