Heart failure

Heart failure from thyrotoxicosis due to Graves’ disease

Case Reports, Volume 20, Issue 1, Pages 1-88 (2021)

A 30-year-old female patient with a past medical history of pernicious anaemia presented with pleuritic chest pain, palpitations, fatigue, coryzal symptoms and a high temperature. She was hypoxic and tachycardic and was extensively investigated as well as aggressively treated. A type 1 ‘gut feeling’ assessment by the admitting medical registrar made the diagnosis possible as thyroid function tests were grossly deranged and pointed to Graves’ disease causing heart failure, complicated by pneumonia. The patient was discharged on carbimazole, antibiotics and beta blockers. Due to a resultant thrombocytopaenia, she has now been swapped onto propylthiouracil and is under active follow up.

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An unusual suspect for heart failure

Picture Quiz - Answers, Volume 19, Issue 1, Pages 1 - 60 (2020)

Constrictive pericarditis though an uncommon diagnosis is a potentially reversible form of heart failure (with surgical pericardiectomy) and hence is imperative to diagnose. Diagnosis is dependent on a high index of clinical suspicion and further testing with appropriate cardiac investigations including cardiac imaging with invasive cardiac catheterisation as the gold standard.

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Management of Acute Admissions of Heart Failure Patients with Kidney Disease

Clinical Reviews, Volume 18, Issue 2, Pages 61 – 136 (2019)

Acute heart failure (HF) admissions are common. They are often associated with prolonged hospitalisations and poor outcomes. One-third of chronic HF patients also suffer from chronic kidney disease (CKD). Hence, acute admissions of HF with CKD are common and are associated with longer length of stay and increased mortality. Hyperkalaemia and acute on chronic renal impairment are important challenges in the management of these cases. Cautious introduction of high-dose diuretic therapy, followed by the re-commencement of renin-angiotensin-aldosterone (RAAS) inhibitors, improves length of stay, quality of life, and prognosis. During an admission on to the medical assessment unit careful monitoring and management of the patient’s clinical condition and biochemistry is essential.

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Problem-based review: The patient with acute heart failure

Trainee Section, Volume 12, Issue 1, Pages 1 - 64 (2013)

Acute heart failure is a common and potentially life threatening presentation to hospitals in the UK. Acute Physicians at the front door of the hospital will often be involved with the initial management of these patients. Despite its many underlying causes, certain general treatment principles exist. We present a typical clinical scenario followed by an overview of the pathophysiology and management of acute heart failure and cardiogenic pulmonary oedema. The aim is to cover a broad spectrum of therapies ranging from medical treatment up to invasive devices, thereby discussing the available options from the Emergency Department to the Intensive Care Unit.

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