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Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...

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Updated: Oct 13, 2025

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

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Ejection fraction - A number to be interpreted with caution!

Konstantin Yastrebov^1,2, Con Manganas^3,4, Tejo Kapalli^1,2

¹Department of Intensive Care Medicine St George Hospital Kogarah New South Wales Australia.

Australasian Journal of Ultrasound in Medicine

|November 11, 2021

Summary

This summary is machine-generated.

Cardiogenic shock after myocardial infarction with ventricular septal defect has high mortality. A case highlights "normal ejection fraction low cardiac output cardiogenic shock," where ejection fraction alone can be misleading for assessing cardiac function.

Keywords:

cardiogenic shock ejection fraction, cardiac output infarct post infarction ventricular septal defect transthoracic echocardiography and transoesophageal echocardiography

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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

Area of Science:

Cardiology
Cardiac Surgery
Intensive Care Medicine

Background:

Cardiogenic shock often complicates acute myocardial infarction (AMI) with ventricular septal defect (VSD).
Despite advances, mortality for AMI with VSD remains high.
Surgical repair of post-infarction VSD can be complex, with potential for complications.

Purpose of the Study:

To present a case of refractory cardiogenic shock after VSD repair.
To illustrate the concept of "normal ejection fraction low cardiac output cardiogenic shock" (nEF-LO-CS).
To emphasize the limitations of relying solely on left ventricular ejection fraction (LVEF) in specific clinical scenarios.

Main Methods:

Case report of a patient with refractory cardiogenic shock post-VSD repair.
Review of clinical presentation, management, and outcomes.
Analysis of cardiac function parameters, including LVEF and cardiac output.

Main Results:

The patient experienced refractory cardiogenic shock despite a seemingly "normal" LVEF post-bovine pericardial patch repair of post-infarction VSD.
The residual functional left ventricular cavity size was insufficient to maintain end-organ perfusion.
This led to a state of nEF-LO-CS.

Conclusions:

Isolated LVEF can be a misleading indicator of cardiac performance in patients with post-infarction VSD and complex cardiac anatomy.
Assessment of cardiac output and end-organ function is crucial in managing cardiogenic shock, even with preserved LVEF.
This case underscores the importance of comprehensive hemodynamic assessment beyond LVEF in critical care cardiology.