|
| Mechanism | Etiology | Specific treatment options |
|
| Myocardial stretch (atrial hypertension, atrial dilatation, reduced contractility) | Fluid overload
Acute mitral insufficiency
Mitral stenosis | Fluid removal (restrictive fluid administration, diuretics, renal replacement therapy)
Intra-aortic balloon pump; cardiac surgery
Valvuloplasty |
|
| Inappropriate oxygen delivery to the myocardium | Myocardial ischemia
Hypovolemia
Anemia | Revascularization
Fluid challenge
Transfusion of red blood cells |
|
| Electrolyte disturbances (risk factors: diuretics, dialysis) | Hypokalemia
Hypomagnesemia | Substitution of potassium (goal K+ 4.5–5.5 mmol/L)
Substitution of magnesium (goal Mg++ > 1.0 mmol/L) |
|
| Systemic and local inflammation | Heart-lung machine
Sepsis
Myocarditis | Steroids; off-pump cardiosurgical techniques
Antimicrobial therapy
Immunosuppression |
|
| Adrenergic overstimulation | Inotropic support
Stress (pain, anxiety) | Reduction of inotropes
Sedation; analgesia; betablockers |
|
| Endocrine disorder | Elevated thyroid hormones
Pheochromocytoma | Betablockers; thyreostatic drugs
Alpha- and betablockers |
|
| Various | Hypothermia | Correction of hypothermia |
|
