{"id":4413,"date":"2021-11-22T07:38:23","date_gmt":"2021-11-22T13:38:23","guid":{"rendered":"https:\/\/ddxof.com\/?p=4413"},"modified":"2022-01-06T11:10:35","modified_gmt":"2022-01-06T17:10:35","slug":"lvad","status":"publish","type":"post","link":"https:\/\/ddxof.com\/lvad\/","title":{"rendered":"LVAD"},"content":{"rendered":"<h2>Brief H&amp;P:<\/h2>\n<p class=\"lead drop-cap\">\nA 48 year-old male with a history of congestive heart failure s\/p left ventricular assist device is brought in by EMS with low-flow alarms. According to prehospital report, the patient had otherwise been in his usual state of health and had been shocked by his ICD multiple times prior to their arrival. No vital signs could be obtained en route.\n<\/p>\n<p>On arrival in the emergency department, the patient was awake and responding appropriately to questions. His MAP was 80mmHg, an audible whir was auscultated from his device and the skin surrounding the percutaneous exit site appeared normal.<\/p>\n<h3>ECG<\/h3>\n<div><a href=\"https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-4417\" src=\"https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg.png\" alt=\"ECG with Ventricular Fibrillation\" width=\"2270\" height=\"1208\" srcset=\"https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg.png 2270w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-300x160.png 300w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-1024x545.png 1024w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-1536x817.png 1536w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-2048x1090.png 2048w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-500x266.png 500w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-150x80.png 150w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-1200x639.png 1200w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-400x213.png 400w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-800x426.png 800w, https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-ecg-200x106.png 200w\" sizes=\"auto, (max-width: 2270px) 100vw, 2270px\" \/><\/a><\/div>\n<h3>POCUS<\/h3>\n<div><a href=\"https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-vfib.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-4418\" src=\"https:\/\/ddxof.com\/wp-content\/uploads\/2021\/11\/lvad-vfib.gif\" alt=\"Ultrasound showing parasternal long axis view of fibrillating heart\" width=\"996\" height=\"642\" \/><\/a><\/div>\n<p>The patient&#8217;s device was inactivated with a magnet to prevent further ineffectual shocks. An arterial line was placed for continuous blood pressure measurement. He was sedated and externally defibrillated with return to normal sinus rhythm prior to admission to the CCU.<\/p>\n<h2>An Algorithm for the Evaluation of Unstable LVAD<sup>1<\/sup><\/h2>\n<p><a href=\"https:\/\/lucid.app\/publicSegments\/view\/862e3c3d-7698-4660-a174-5aa9e582e743\/image.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full\" src=\"https:\/\/lucid.app\/publicSegments\/view\/862e3c3d-7698-4660-a174-5aa9e582e743\/image.png\" alt=\"Algorithm for the Evaluation of Unstable LVAD\" width=\"4796\" height=\"1723\" \/><\/a><\/p>\n<h2>Reference<\/h2>\n<p>Stenberg R, Shenvi C. Targeted evaluation of patients with left ventricular assist devices and shock or hypotension. <em>Ann Emerg Med<\/em>. 2020;76(1):34-41.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Brief H&amp;P: On arrival in the emergency department, the patient was awake and responding appropriately to questions. His MAP was 80mmHg, an audible whir was auscultated from his device and the skin surrounding the percutaneous exit site appeared normal. ECG POCUS The patient&#8217;s device was inactivated with a magnet to prevent further ineffectual shocks. An&#8230; <a class=\"more-link\" href=\"https:\/\/ddxof.com\/lvad\/\">Continue reading <span class=\"meta-nav\">&#8594;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[103,220],"tags":[188],"series":[],"class_list":["post-4413","post","type-post","status-publish","format-standard","hentry","category-cardiology","category-thoracic-surgery","tag-arrhythmia"],"better_featured_image":null,"acf":{"algorithm_urls":["https:\/\/lucid.app\/publicSegments\/view\/5b2104b9-f414-4053-9984-a588342a5961\/image.png","","","","",""],"algorithm1":["https:\/\/lucid.app\/publicSegments\/view\/5b2104b9-f414-4053-9984-a588342a5961\/image.png","3600","2098"]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Differential Diagnosis of LVAD<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ddxof.com\/lvad\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Differential Diagnosis of LVAD\" \/>\n<meta property=\"og:description\" content=\"Brief H&amp;P: On arrival in the emergency department, the patient was awake and responding appropriately to questions. His MAP was 80mmHg, an audible whir was auscultated from his device and the skin surrounding the percutaneous exit site appeared normal. ECG POCUS The patient&#8217;s device was inactivated with a magnet to prevent further ineffectual shocks. An... 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