Hypotension, tachycardia, respiratory failure, bilateral pulmonary edema, and cardiogenic shock
(1) IV hydrocortisone loading dose 100 mg and thereafter 10 mg/h (2) Mechanical ventilation and continuous norepinephrine at 4.4 μg/kg min (3) At discharge, oral hydrocortisone and fludrocortisone, standard
(i) At discharge, the LVEF improved to 52% with no evidence of wall-motion abnormalities
Nausea, weakness, progressive dyspnea, asystolic cardiac arrest, pericardial effusion, severe biventricular failure, and cardiogenic shock
(1) TandemHeart implantation (2) IV hydrocortisone loading dose 100 mg and thereafter 50 mg/8 h (3) Weaned to physiologic dose of oral hydrocortisone by discharge (4) 2 months after discharge, mineralocorticoid replacement for hypotension
(i) At 2 weeks after RVAD and LVAD removal, normal biventricular function (ii) At 2 months, remained well
Mozolevska et al.
Orthopnea, dyspnea, elevated jugular venous pressure, elevated BNP, dilated LV, severe systolic dysfunction, and bilateral pleural effusions
(1) IV furosemide, 40 mg oral at discharge (2) Ramipril 5 mg (3) Bisoprolol 10 mg (4) Fludrocortisone dosage decreased by 50% (from 0.1 mg daily), prednisone unchanged at 5 mg daily
(i) LVEF improved to 44
LV, left ventricle; IV, intravenous; CHF, congestive heart failure; LVEF, left ventricular ejection fraction; ICU, intensive care unit; RVAD, right ventricular assist device; LVAD, left ventricular assist device; BNP, brain natriuretic peptide.
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