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Related Concept Videos

Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Heart Failure III: Clinical Manifestations01:26

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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Heart Failure Drugs: β-Blockers01:22

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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Heart Failure II: Pathophysiology01:29

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Heart Failure I: Introduction01:27

Heart Failure I: Introduction

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Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
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Implantation of Total Artificial Heart in Congenital Heart Disease
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Heart failure induced by itraconazole.

Ana Rodrigo-Troyano1, Marta M Mediavilla2, Noé Garin2

  • 1Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.

Medicina Clinica
|December 5, 2016
PubMed
Summary

Itraconazole, an antifungal, may be linked to congestive heart failure (CHF). A patient

Keywords:
Drug-Related Adverse ReactionsHeart failureInsuficiencia cardíacaItraconazolItraconazoleReacciones adversas a medicamentos

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Area of Science:

  • Cardiology
  • Pharmacology
  • Infectious Diseases

Background:

  • Itraconazole is a widely used antifungal imidazole for treating aspergillosis.
  • Limited evidence exists regarding the association between itraconazole and congestive heart failure (CHF).
  • Previous reports are primarily based on post-market drug surveillance cases.

Observation:

  • A case report details a 76-year-old male with hypertension and severe COPD (GOLD D).
  • The patient developed heart failure following the initiation of itraconazole therapy.
  • Symptoms resolved upon itraconazole withdrawal and diuretic treatment.

Findings:

  • Validated algorithms indicated a probable association between itraconazole and the onset of CHF.
  • This case highlights a potential adverse drug event not fully established in medical literature.
  • The temporal relationship between itraconazole administration and CHF onset was observed.

Implications:

  • The association between itraconazole and CHF requires further investigation through observational studies.
  • Clinicians should consider CHF as a potential adverse effect of itraconazole.
  • Contraindication of itraconazole in patients with pre-existing structural heart disease may be warranted.