الفهرس 
Physiology of cardiac muscleOnly 14 pages are availabe for public view
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Abstract
Heart failure is a term used to describe the state that develops when the heart cannot maintain an adequate cardiac output.
The underlying mechanism may be cardiac or extra-cardiac, and may be transient and reversible with resolution of the acute syndrome or may induce permanent damage leading to chronic heart failure. The cardiac dysfunction can be related to systolic or diastolic myocardial dysfunction, acute valvular dysfunction, abnormalities of cardiac rhythm.
In pharmacological management we may use diuretics as furosemide,bumetanide or torsemide, vasodilators as nitroglycerin, isosorbide dinitrate ,nitroprusside or nesiritide or inotropics as dobutamine,dopamine,milrinone,enoximone,levosimendan,
epinephrine or norepinephrine.
In non pharmacological management we may use intra aortic balloon pump which is a mechanical device that is used to decrease myocardial oxygen demand while at the same time increasing cardiac output. By increasing cardiac output it also increases coronary blood flow and therefore myocardial oxygen delivery. It consists of a cylindrical balloon that sits in the aorta and counterpulsates. That is, it actively deflates in systole increasing forward blood flow by reducing afterload, and actively inflates in diastole increasing blood flow to the coronary arteries. These actions have the combined result of decreasing myocardial oxygen demand and increasing myocardial oxygen supply.
Ventricular assist devices (VAD) the clinical application of these devices grew from experience with their application in the operating room. Unlike the IABP, VADs function to reduce myocardial work by reducing ventricular preload while maintaining systemic circulation. They may be used for right ventricular (RVAD), left ventricular (LVAD), or biventricular (BiVAD) support for short-term (less than 1 week) or longer term support and for permanent (destination therapy) use. The device may be completely extracorporeal, implantable but with percutaneous power support or totally implantable.
There are new emerging under trial methods such as stem cells, tissue engineering or gene therapy.
In this essay we concern with perioperative management of patient with acute heart failure,which includes preoperative assessment of patient history,clinical picture and investigations, preoperative preparation then intraoperative management and choice of appropriate anesthesia then the postoperative management .