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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Mitral Regurgitation I: Introduction01:20

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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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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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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Related Experiment Video

Updated: Dec 31, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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SIRS Triggered by Acute Right Ventricular Function, Mimicked Septic Shock.

Yingke He1, John Ong2, Thuan Tong Tan3

  • 1Division of Anaesthesiology, Singapore General Hospital, Singapore, Singapore.

Journal of Critical Care Medicine (Universitatea De Medicina Si Farmacie Din Targu-Mures)
|January 10, 2020
PubMed
Summary
This summary is machine-generated.

Acute right ventricular dysfunction can trigger systemic inflammatory response syndrome (SIRS), mimicking septic shock. Prompt diagnosis via Point of Care Ultrasound (POCUS) and treatment with milrinone led to recovery and ICU discharge.

Keywords:
Point of Care Ultrasound (POCUS)acute right ventricular dysfunctionacute right ventricular failuresepsisseptic shocksystemic inflammatory response syndrome

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Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Critical Care

Background:

  • Systemic inflammatory response syndrome (SIRS) is a complex immune response often triggered by non-infectious causes like trauma or pancreatitis.
  • While chronic heart failure is linked to SIRS, acute right ventricular dysfunction has not been previously recognized as a trigger.
  • This case highlights a novel association between acute right ventricular dysfunction and SIRS.

Purpose of the Study:

  • To report a case of acute right ventricular dysfunction triggering SIRS.
  • To illustrate how this condition can mimic septic shock.
  • To emphasize the importance of considering right ventricular dysfunction in undifferentiated shock.

Main Methods:

  • A 70-year-old male presented with refractory hypotension and elevated inflammatory markers post-surgery.
  • Initial misdiagnosis of septic shock was made; pulmonary embolism was identified but treatment was ineffective.
  • Point of Care Ultrasound (POCUS) diagnosed acute right ventricular dysfunction.

Main Results:

  • Treatment with intravenous milrinone improved the patient's blood pressure.
  • Inflammatory markers normalized following milrinone administration.
  • The patient experienced a prompt discharge from the Intensive Care Unit.

Conclusions:

  • Acute right ventricular dysfunction can precipitate SIRS.
  • SIRS secondary to right ventricular dysfunction can be mistaken for septic shock.
  • Timely diagnosis and treatment of right ventricular dysfunction are crucial to avoid delayed management of SIRS.