Title:Advanced Strategies in the Diagnosis and Treatment of Patients with Coronary Artery Disease and Heart Failure: When Heart Failure Causes Ischemia and Angiotensin Converting Enzyme Inhibitor and Betablockers Helps in Diuresis
Volume: 24
Issue: 4
Author(s): Thach Nguyen*, Nguyen Van Lanh, Vo Minh Viet, Lam Hoang Phuc, Trung N. Pham, Khanh Duong, Luke Ashwin Lawrence, Vien T. Truong and Gianluca Rigatelli
Affiliation:
- Department of Cardiovascular Research, Methodist Hospital, Merrillville IN,United States
Keywords:
Heart failure, Size and expansion of common femoral vein, Fluid overload, Venous fluid volume, Intravascular fluid volume,
Coronary Artery Disease (CAD).
Abstract: In the diagnosis and management of patients with Coronary Artery Disease (CAD) and chronic Left
Ventricular (LV) dysfunction or Heart Failure (HF), there are many uncertainties because of the non-specificity of
the symptoms and signs of HF. Usually, severe CAD causes LV dysfunction. However, not rarely, LV dysfunction
is the cause or aggravation of ischemia to many subsets of patients with or without CAD.
In this article, the care of patients with CAD with LV dysfunction, along with the challenges of diagnosing asymptomatic
HF and the criteria for monitoring success are presented. Then the evidence of LV dysfunction triggering
or aggravating ischemia is discussed. The newest methodology of assessing the venous blood volume
which causes the main presentations of HF when its filling capacity is exceeded will also be presented in details.
In summary, the effects of fluid mobilization by conventional medications for CAD (e.g Angiotensin Converting
Enzyme Inhibitors (ACEI) or Beta-blockers (BB) and their therapeutic mechanisms are discussed.
The goal of this review is to present the cardiologist consultants strong scientific evidence of detrimental interaction
between CAD and LV dysfunction and the therapeutic action of ACEI and BB in the mobilization of venous
fluid. As a result, the management of patients with CAD and HF could be exercised on an advanced level of expertise.
