Acute heart failure is a potentially life threatening situation where correct, rapid therapy can have a life saving impact. In this rapidly changing area of medicine this text aims to bring the latest understanding of the pathophysiology together with a practical guide to diagnosis and management using a thoroughly evidence based approach. This will appeal to a wide audience of health care professionals who will treat patients with acute heart failure, including doctors, medical students, nurses, and other professionals in the Emergency Department, General Internal Medicine, Anaesthetics, Cardiology (Medicine and Surgery) and Critical Care settings. It may be used as an evidence based guide for the junior practitioner or as an aide-memoire for the more senior. Always keeping the underlying pathophysiology at the forefront of the discussion, the reader is encouraged to understand the aetiology of the acute situation and how to direct management in order to correct the abnormal physiology. Each chapter is heavily referenced allowing the reader to easily refer to the original experimental studies and pursue topics in more detail if required. This text is a valuable addition to any practitioner who treats patients with acute heart failure and wants a deeper understanding of the condition.

For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.

Te practice of intensive care medicine is at the very forefront of titration of treatment andmonitoringresponse. Te substrateofthiscareisthe criticallyill patientwho,by defnition, is at the limits of his or her physiologic reserve. Such patients need immediate, aggressive but balanced life-altering interventions to minimize the detrimental aspects of acute illness and hasten recovery. Treatmentdecisionsandresponsetotherapyareusually assessed by measures of physiologic function, such as assessed by cardio-respiratory monitoring. However, how one uses such information is ofen unclear and rarely supported by prospective clinical trials. In reality, the bedside clinician is forced to rely primarily on physiologic principles in determining the best treatments and response to therapy. However, the physiologic foundation present in practicing physicians is uneven and occasionally supported more by habit or prior training than science. A series of short papers published in Intensive Care Medicine since 2002 under the heading Physiologic Notes attempts to capture the essence of the physiologic perspectives that underpin both our understanding of disease and response to therapy. Tis present volume combines the complete list of these Physiologic Notes up until July 2006 with the ass o cia t ed r e vie w a r tic les o v er t h e s a m e in t er val t ha t a ls o addr ess e d t hes e cen tral issues.

The heart and lung are intricately linked. When the heart is affected by disease, the lungs will often show some related pathological or clinical conditions and vice versa. Pulmonary heart disease is by definition a condition when the lungs cause the heart to fail. The left ventricle in combination with the other structures in the “left heart” pumps blood throughout the body. The right ventricle (and structures of the “right heart”) pumps blood to the lungs where it is oxygenated and returned to the left heart for distribution. In normal circumstances, the right heart pumps blood into the lungs without any resistance. The lungs usually have minimal pressure and the right heart easily pumps blood through. However when there is lung disease present, like emphysema, chronic obstructive lung disease (COPD) or pulmonary hypertension- the small blood vessels become very stiff and rigid. The right ventricle is no longer able to push blood into the lungs and eventually fails. This is known as pulmonary heart disease. Pulmonary heart disease is also known as right heart failure or cor pulmonale. The chief cause of right heart failure is the increase in blood pressure in the lungs (pulmonary artery).

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It is quite natural that literature related to car heart disease, cardiomyopathy, pulmonary and diac structure, function, pathology, and patho pulmonary vascular disease, trauma, acquired valvular disease, congenital disease, and surgi physiology has emphasized the left heart and systemic circulation. The relative lack of im cal considerations. The pathologic and clinical relevance of myocardial infarction of the right portance of the right ventricle was supported by studies performed in the 1940s and 1950s ventricle has only been documented over the which suggested that the right ventricular free last 15 years. The chapter on right ventricular wall could be effectively destroyed in an animal infarction integrates clinical, functional, patho model without detectable untoward hemody physiologic, and pathologic observations to pro namic consequences. The relative inadequacy vide the reader with a thorough review, equally of noninvasive tools to study right ventricular relevant to the clinician and investigator. The contribution on dilated cardiomyopathy pro structure and function obviated detailed and systematic investigation. However, over the vides novel insight into the impact of right ventricular performance on the functional in past 15 years there has been a resurgence of interest in the right ventricle by a variety of capacity accompanying left heart failure. A book dealing with the right ventricle would investigators. The skeptic would argue that this renewed interest resulted from an exhaustion be incomplete without at least cursory reference we have of clinically-related observations that could be to the pulmonary circulation.

This comprehensively covers everything from pathophysiology to the evaluation of patients presenting with heart failure to medical management, device therapy, heart transplantation and mechanical circulatory support, and include relevant cardiac imaging studies such as echocardiograms and magnetic resonance imaging studies which could be seen in their entirety as well as pathology slides, hemodynamic tracings and videos of cardiac surgery such as heart transplants and ventricular assist device implantation. Finally, the book would have videos of patients with heart failure, heart transplants or ventricular assist devices, describing their clinical presentation and experiences. It is structured so that it can be used as a guide by physicians studying for the general Cardiology or Advanced Heart Failure and Cardiac Transplantations Boards.