Cardiac Emergencies in the ICU

Preface

Nitin Puri, MD, FCCP

Crit Care Clin 30 (2014)http://dx.doi.org/10.1010749-0704/14/$ – see fro

Shashank S. Desai, MD

Editors

Critical Care and Cardiology have a deeply intertwined history. Modern intensive careunits have significant roots in the Coronary Care Units established in the 1960s. Theidea of cohorting cardiac patients in a specific location led to a standardization ofthe management of acute myocardial infarction patients. This was accomplishedwith continuous ECG monitoring, CPR capabilities, and trained nurses that could startresuscitation. A dramatic reduction in myocardial infarction mortality occurred and theidea spread worldwide. Today, it would be difficult to find an Intensivist who would notknow how to treat a myocardial infarction and understand the importance of the“golden hour.” A similar revolution is ongoing in the shared space between CriticalCare, Cardiology, and Cardiac Surgery with new therapeutic options to treat diseasespreviously thought intractable.In this issue of the Critical Care Clinics, we seek to explore the common ground

between these fields. Although mechanical circulatory support (MCS) devices havebeen around for more than 50 years, the growing potential for their use in the criticallyill is a relatively new phenomenon. The indications, the pitfalls, and the therapeuticpotential of different MCS devices are reviewed in this issue. The perplexing diseaseprocesses of right heart failure and submassive pulmonary embolisms are similarlydelved into. Paradigm-shifting therapies are considered in the Neurologic Complica-tions of Cardiac Emergencies article. “Perioperative Complications of Cardiac Surgeryand Postoperative Care” are examined as Intensivists become more involved in thecare of cardiac surgery patients. The new pharmaceutical and the MCS options forcritically ill cardiac patients are evolving into a new subdivision of critical care that allIntensivists must be familiar with.Each editor would like to thank his colleagues, who took their time out of their sched-

ules to share their expertise about this rapidly expanding field. We both appreciatethose who have guided us in our careers as mentors, colleagues, and trainees. Thereis much that can be learned from all around us, if we choose to listen carefully. Dr NitinPuri would like to thank his father, Dr Vinod Puri, and his mother, Dr Kasturi Puri, for hislove of medicine, and Dr Richard Carlson, for showing him the path to success as aphysician and an educator. Dr Desai would like to express special gratitude for theconstant support and encouragement of his loving wife, Nina Phatak, without whom

xi–xii6/j.ccc.2014.05.002 criticalcare.theclinics.comnt matter � 2014 Elsevier Inc. All rights reserved.

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success would not be possible, and children, Dhilan, Annika, and Lara, who makeeveryday activities worthwhile. Both editors would like to thank their colleagues atthe Inova Fairfax Heart Institute and the Heart Failure/Transplant Program at InovaFairfax Hospital for seemingly daily turning miracles into reality.

Nitin Puri, MD, FCCPPulmonary/Critical Care

Cardiovascular Intensive Care UnitInova Fairfax Hospital

Falls Church, VA 22042, USA

Shashank S. Desai, MDHeart Failure/Transplant Program

Inova Fairfax HospitalInova Heart and Vascular Institute

3300 Gallows RoadFalls Church, VA 22042, USA

E-mail addresses:purimon@gmail.com (N. Puri)

shashank.desai@inova.org (S.S. Desai)