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martes, 29 de agosto de 2017

Ventolin in HF

An online community of practice for Canadian EM physicians
CanadiEM - By Ponn Benjamin - August 29, 2017
"Can Ventolin improve wheeze in heart failure?
Breathlessness in heart failure patients led James Hope to coin the term “cardiac asthma” in 18331, and by 1854 cardiac asthma was considered a disease state. Sir William Osler’s classic description (1897) has withstood the test of time: “In the case of advanced arteriosclerosis, there are often attacks of dyspnea of great intensity recurring in paroxysms, often nocturnal. The patient goes to bed feeling quite well, and in the early morning hours wakes in an attack which, in its abruptness of onset and general features, resembles asthma"...
In conclusion, the current evidence does not support or refute the use of ventolin in cardiac asthma. Identifying the etiology behind CHF decompensation will determine the appropriate therapeutic interventions. The patient’s medical history, vital signs, and physical exam may determine whether it should be used. It is reasonable to consider Ventolin therapy in patients with CHF who have a past medical history of asthma or COPD."