Placement of a pulmonary artery catheter (PAC), commonly known as a Swan-Ganz catheter, provides hemodynamic data that is vital for clinicians treating patients with acute decompensated heart failure or cardiogenic shock. While routine use has been shown to not be beneficial, there are many instances in which hemodynamic monitoring through the use of a Swan is highly indicated.
Cardiogenic shock represents a dynamic set of conditions, presentation profiles and pathophysiologic mechanisms whose mortality has not changed in more than 20 years. While almost 75 percent is due to predominant left ventricular failure, a quarter is due to something else, such as a rupture or tamponade, right ventricle shock or acute severe mitral regurgitation.
Heart failure and diabetes are closely intertwined. Diabetes affects not only coronary artery blood flow, but also the myocardium. Patients with type 2 diabetes are at risk of heart failure due to intrinsic myocardial disease, resulting in increased myocardial hypertrophy, fibrosis and stiffness. This can also lead to a form of heart failure described in literature as diabetic cardiomyopathy.
Patients with chronic pancreatitis often experience intractable pain. Patients make frequent trips to the emergency department and may have numerous hospital admissions. They also can experience significant lifestyle disruptions and a greatly diminished quality of life.
Like all transplant recipients, patients who have received a liver transplant have complex and unique medical needs. Physicians who are following these patients must be proactive about preventive care, recognize potential complications and manage any post-transplant conditions that develop.
