Glossary of terms

Abdomen: the part of the body that lies between the chest and waist.

AC Adapter: a power adapter that plugs into a wall electrical outlet.

ACE inhibitors: a class of blood pressure-lowering drugs which lower the blood pressure by relaxing arteries. Lower blood pressure improves the pumping efficiency of a weak or damaged heart, improving cardiac output in patients with heart failure.

Adult Congenital Heart Failure: a clinical syndrome or a collection of symptoms that indicate the heart is unable to pump enough blood to meet the body’s energy demands. Adults with congenital heart disease are an important emerging patient group. Despite improved survival to adulthood, many patients will continue to have problems with residual shunts, valvular heart disease, ventricular dysfunction, heart failure and arrhythmias.  See: National Heart, Lung and Blood Institute

Advanced Heart Failure: a stage of heart failure in which therapies for earlier stages, such as optimal medical management with drugs, are not enough to provide enough heart function for the patient.

AHA/ACC Class D Heart Failure: an approach to the classification of chronic HF, initially published in 2001, that was developed to emphasize both the evolution and the progression of chronic HF and to implement early therapeutic interventions to ultimately reduce morbidity and mortality. Four stages of HF were identified. Class D Stage IV patients are those with advanced structural heart disease and marked symptoms of HF at rest despite maximal medical therapy who require specialized interventions. Such patients are unable to carry out any physical activity without discomfort and show symptoms of cardiac insufficiency at rest. The patient experiences extreme discomfort as activity increases.

AMI, MI, Acute Infarction (also known as a heart attack): acute myocardial infarction (MI) is defined as death or necrosis of myocardial cells. It is an end-stage diagnosis of acute coronary syndromes of which there are two types, non-ST-segment elevation MI (NSTEMI) and ST-segment elevation MI (STEMI). The severity of an MI is dependent upon three factors: the level of the occlusion in the coronary artery, the length of time of the obstruction, and the presence or absence of collateral circulation. The most important treatment in myocardial infarction is restoring the blood flow to the heart either through an angioplasty or thrombolysis. See: Cleveland Clinic Foundation

Angiogram:  a series of x-rays of the blood vessels in the heart taken in rapid sequence following the injection of a contrast substance into the blood stream.

Angioplasty: performed in the catheterization lab in which a catheter-guided balloon is used to open a narrowed coronary artery. A stent (a wire-mesh tube that expands to hold the artery open) is usually placed at the narrowed section during angioplasty.

Angiotensin Receptor Blockers (ARBs): A class of drugs which lower blood pressure by relaxing the arteries. Lower blood pressure improves the pumping efficiency of a weak or damaged heart, improving cardiac output in patients with heart failure.

Anticoagulants: non habit-forming medications that keep existing blood clots from growing larger as well as prevents the formation of new blood clots. Heparin is an example.

Antiplatelet Agents: a group of drugs used to keep blood clots from forming by preventing blood platelets from sticking together. They help prevent clotting in patients who have had a heart attack, unstable angina, ischemic strokes, transient ischemic attacks (TIA) and other forms of cardiovascular disease. They are usually prescribed preventively, when plaque buildup is evident in the arteries but there is not yet a large obstruction. Aspirin, dipyridamole and clopidogrel are examples. See: American Heart Association

Antiarrhythmic Agents: a group of pharmaceuticals such as Amiodarone, Procainamide, Digoxin, and Adenosine that are used to suppress fast rhythms of the heart (cardiac arrhythmias). The Vaughan Williams classification is one of the most widely used classification schemes for antiarrhythmic agents. This scheme classifies a drug based on the primary mechanism of its antiarrhythmic effect.

Aorta: the large arterial trunk that carries blood from the heart to be distributed by branch arteries through the body.

Aortic Regurgitation (“leaky” aortic valve): the diastolic flow of blood from the aorta into the left ventricle. Regurgitation is caused by incompetence of the aortic valve or any disturbance of the valvular apparatus (eg, leaflets, annulus of the aorta) resulting in diastolic flow of blood into the left ventricular chamber. See: E Medicine from Web MD

Aortic Valve: a valve with 3 cusps between the left ventricle and the aorta.

Apex: blunt rounded end of the heart, directed downward, forward, and to the left.

Arrhythmias: problems that affect the electrical system of the heart, producing abnormal heart rhythms. They can cause the heart to pump less effectively. See: American Heart Association

Arterial Blood Pressure: pressure determined directly by two major physical factors, the arterial blood volume and the arterial compliance (elasticity). The pressure of the circulating blood on the arteries. See:

Arteries: the thick, muscular tubes that carry blood away from the heart.

Aspirin: acetylsalicylic acid (ASA); a widely used analgesic, antipyretic, and anti-inflammatory agent. Low-dose long-term aspirin irreversibly blocks the formation of thromboxane A2 in platelets, producing an inhibitory effect on platelet aggregation, and this blood-thinning property makes it useful for reducing the incidence of heart attacks. Aspirin produced for this purpose often comes in 75 or 81 mg dispersible tablets and is sometimes called “Junior or baby aspirin”. Higher doses of aspirin are also given immediately after an acute heart attack. See: Wikipedia

Atherosclerosis:  a condition where cholesterol and platelets accumulate on the inside surface of the arteries and cause narrowing, or hardening of the arteries. Atherosclerosis can lead to Coronary Artery Disease.

Atrium:  an upper chamber of the heart. Right atrium receives unoxygenated blood from the body. Left atrium receives oxygenated blood from the lungs.

aVAD®: The name of ReliantHeart’s direct implant VAD.

Battery:  one of the power sources used to run the HeartAssist5 Ventricular Assist System. Two batteries, or one battery and an AC adapter or DC adapter are required at all times.

Battery Charger: the unit used to charge batteries. With the HeartAssist5 Ventricular Assist System, up to four batteries may be charged at a time.

Beta-blockers: a class of drugs for hypertension or heart failure that decrease the force and rate of heart contractions by modulating the autonomic nervous system.

Bilirubin: the main bile pigment that is formed from the breakdown of heme in red blood cells. The broken down heme travels to the liver, where it is secreted into the bile by the liver. Normally, a small amount of bilirubin circulates in the blood. Serum bilirubin is considered a true test of liver function, as it reflects the liver’s ability to take up, process, and secrete bilirubin into the bile.

BVAD, Bi-ventricular Assist Device: a ventricular assist device with the combined functions of both left and right ventricular assist devices. Implantation of biventricular assist devices (BVAD) is an accepted therapy for acute cardiac failure in different settings: post cardiotomy ventricular failure, acute myocardial infarction, cardiomyopathy or failed transplant. Intended endpoints are bridge to recovery of the native heart or heart transplantation.

Bi-ventricular Failure: a common, progressive, complex clinical syndrome with high morbidity and mortality. Bi-ventricular heart failure is, as the name implies, a failure of both the left and right ventricles.

Blood Clots: the conversion of blood into a semisolid gel.

Blood Thinner: medication used to prevent blood clots or keep the blood in a liquid form (for example, Coumadin®).

Blood Vessels: an extensive network of flexible tubes that carries blood to and from the heart and throughout the body. The blood vessels are the transportation system of the body. The blood vessels include arteries, capillaries and veins.

Blood Urea Nitrogen (BUN): a measure primarily of the urea (i.e., nitrogenous substances) level in blood. Urea is cleared by the kidney largely by filtration. Diseases that compromise the function of the kidney frequently lead to an increased BUN.

Body Mass Index (BMI): a number calculated from a person’s weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems. See: Center for Disease Control and Prevention

Body Surface Area (BSA): the body surface area (BSA) is the measured or calculated surface of a human body. For many clinical purposes BSA is a better indicator of metabolic mass than body weight because it is less affected by abnormal adipose mass. Estimation of BSA is simpler than many measures of volume. See: Wikipedia

Bridge-To-Recovery: a medical device that can support the heart until it is able to recover and operate on its own.

Bridge-To-Transplant: a medical device that can temporarily function in place of a heart until a suitable heart transplant becomes available.

Bridge-to-transplantation (BTT): temporary mechanical circulatory support (MCS) for advanced heart failure patients waiting for a donor heart to become available, BTT involves implantation of a ventricular assist device (VAD) or a temporary artificial heart (SynCardia TAH).

CABG (pronounced “Cabbage”)Coronary Artery Bypass Grafting: a heart surgery procedure that treats the symptoms of coronary artery disease. CABG surgery reroutes (or ‘bypasses’) the blood flow around the blockages in the coronary arteries, restoring blood flow to the heart muscle itself.

Cannulae: tubes that connect the heart and blood vessels to the pump.

Cardiac Arrest: the abrupt cessation of normal circulation of the blood due to failure of the heart to contract effectively during systole. See: Wikipedia

Cardiac Cycle: one total heartbeat, one complete contraction and relaxation of the heart.

Cardiac Graft Rejection: rejection of a coronary artery bypass graft (or CABG)

Cardiac Index: the amount of blood pumped by the heart, per minute, per meter square of body surface area. Also known as a cardiodynamic measure based on the cardiac output. Cardiac output can be indexed to a patient’s body size by dividing by the body surface area to yield the cardiac index. See: Medicine

Cardiac Inotropes: the term is used in reference to various drugs that affect the strength of contraction of heart muscle (myocardial contractility). Both positive and negative inotropes are used in the management of various cardiovascular conditions. The choice of agent largely depends on specific pharmacological effects of individual agents with respect to the condition. Examples of positive inotropic agents include: calcium sensitizers such as Levosimendan, cardiac glycosides such as Digoxin, catecholamines such as Dopamine and Dobutamine. Negative inotropic agents include beta blockers, Diltazem and Verapamil.

Cardiac Output (CO): the amount of blood the left ventricle ejects into the systemic circulation in one minute, measured in liters per minute (l/min).  CO = SV x HR where SV= stroke volume and HR= heart rate.

Cardiac resynchronization therapy (CRT): a therapy to restore normal electrical heart rhythm in patients with heart failure or arrhythmias.

Cardiogenic Shock (CS): a condition that often takes place after a heart attack when cells in the heart start to die, due to the failure of the heart to pump an adequate amount of blood to the heart.

Cardiologist: specialists in the structure, function and disorders of the heart, cardiologists are the first line of treatment for many heart failure patients. Heart failure cardiologists focus exclusively on patients with this condition. 

Cardiomyopathies: a serious disease affecting the heart. It involves an inflammation and reduced function in heart muscle. There are multiple causes including viral infections (myocarditis). In cardiomyopathy, the heart muscle becomes inflamed and weakened, causing symptoms of heart failure, which can mimic a heart attack. See: American Heart Association

Cardiopulmonary: pertaining to or affecting both the heart and the lungs and their functions.

Cardio-pulmonary Bypass: bypass of the heart and lungs as, for example, in open heart surgery. Blood returning to the heart is diverted through a heart-lung machine (a pump-oxygenator) before returning it to the arterial circulation. The machine does the work both of the heart (pump blood) and the lungs (supply oxygen to red blood cells).See:

Cardiopulmonary Resuscitation (CPR): is an emergency first aid protocol for an unconscious person on whom neither breathing nor pulse can be detected. See: Wikipedia

Cardiothoracic surgeons: surgeons specially trained to operate on the heart and chest cavity, performing heart transplants, VAD implantations, and coronary artery bypass grafts (CABGs).

Cardiovascular: pertaining to the heart and blood vessels

Catheterization (cath) Lab: a facility in most hospitals in which minimally invasive cardiac procedures, like stent placement and angioplasty take place, most often by a cardiologist via a catheter. The lab is often one of the first stops in the hospital for patients experiencing cardiac problems, before they move to the surgical suite where more invasive procedures, like VAD placement or cardiac surgery, take place.  There are approximately 1,600 U.S. hospitals with cath labs.

CE-Mark: the approval of manufacturing and quality systems identified with the ISO 9001 certification. This label allows a medical device company to commercialize products in Europe.

Centrifugal Pump Technology: as blood is drawn into the pump, a paddlewheel like component (impeller) forces the blood toward the outside walls and expels it through an opening.

Cerebrovascular Event: an acute temporary or permanent neurologic injury whereby the blood supply to a part of the brain is interrupted. Stroke or cerebrovascular accident (CVA) can also be said to be a syndrome of sudden, permanent loss of neuronal function due to disturbance in cerebral perfusion. This disturbance in perfusion is commonly on the arterial side of the circulation, but can be on the venous side. The part of the brain with disturbed perfusion can no longer receive adequate oxygen carried by the blood; brain cells are therefore damaged or die, impairing function from that part of the brain.  See: Wikipedia

Class IV Heart Failure: end stage heart failure in which an individual is unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency at rest. If any physical activity is undertaken, discomfort is increased. In order to determine the best course of therapy, physicians often assess the stage of heart failure according to the New York Heart Association (NYHA) functional classification system. This system relates symptoms to everyday activities and the patient’s quality of life. See: The stages of HF

CMS: the Centers for Medicare and Medicaid Services, a division of Health & Human Services (HHS), the largest payer of healthcare in the U.S. Patients over 65 or with disabilities qualify for coverage from the U.S. Government.

Coagulation: 1(a): the process of becoming viscous, jellylike, or solid ; especially : the change from a liquid to a thickened curdlike state not by evaporation but by chemical reaction <the spontaneous coagulation of freshly drawn blood> <the coagulation of egg albumen by heat> (b): the process by which such change of state takes place consisting of the alteration of a soluble substance (as a protein) into an insoluble form or of the flocculation or separation of colloidal or suspended matter. 2: a substance or body formed by coagulation. There are three systems that are involved in the coagulation process: 1) platelets 2) pro-coagulant system 3) fibrinolytic system. In artificial heart or ventricular assist device implantation it is necessary to achieve a new equilibrium among these systems. See: Wikipedia

Congestive Heart Failure (CHF): a condition in which the heart’s function as a pump is inadequate to meet the body’s needs. Because of impaired pumping action, the blood becomes congested and can lead to fluid being backed up in the veins and accumulating in the lungs and extremities.  A poor blood supply resulting from CHF may cause the body’s organ systems to fail.  See:

Continuous inotropic infusion:  intravenous (IV) administration of inotropes, medications which increase the pumping efficiency of the heart. 

Console: the part of a circulatory support system that drives the blood pumps, thus allowing the blood to flow through its normal cycle. The console is powered by electricity and has a back-up battery.

Controller: a small computer that operates the VAD and communicates information about how the VAD is working.

Coronary Artery Bypass Grafting (CABG): commonly called heart bypass, CABG is an open-heart surgery that reroutes (or ‘bypasses’) blood flow around blockages in the coronary arteries, restoring blood flow to the heart muscle.

Coronary Artery Disease (CAD): conditions such as atherosclerosis which cause narrowing of the coronary arteries resulting in decreased blood flow to the heart muscle. See: National Heart, Lung and Blood Institute

Coronary Heart Disease (CHD) or Coronary Artery Disease (CAD):   a condition in which plaques containing cholesterol and platelets block arteries, decreasing blood flow and leading to chest pain, heart attacks, and heart failure.

Creatinine: a breakdown product of creatine phosphate generated from muscle metabolism. Creatinine is usually filtered out by the kidneys and leaves the body. If a patient’s kidneys are not working well, creatinine will build up in the blood and can serve as a warning sign for lack of kidney function and cardiovascular disease (CVD). Normal creatinine levels are less than 1.2 mg/dL. Kidney problems can be a complication of heart failure. In heart failure the kidneys are less able to dispose of sodium and water, causing fluid retention in the tissues. See: Wikipedia

DC Adapter: a power adapter that uses power from an automobile electrical outlet to run the controller and VAD.

Destination Therapy (DT):  long-term mechanical circulatory support for advanced heart failure patients who are not eligible for a heart transplant.

Diaphragm: a sheet of muscle separating the thorax and abdomen

Diastole: the period of ventricular relaxation and blood filling. See Human Physiology, Vander et al. McGraw Hill, 6th ed. 1994.

Diastolic Pressure: the minimum arterial pressure during relaxation and dilatation of the ventricles of the heart when the ventricles fill with blood. It is the minimum pressure that occurs just before ventricular ejection begins. In a blood pressure reading, the diastolic pressure is typically the second number recorded. See:

Dilated: to become wider, larger; expand.

Dilated Cardiomyopathy: a large subset of congestive heart disease with systolic and frequently diastolic dysfunction in CHF cases. These cases are differentiated logistically, but not necessarily physiologically, from those due to ischemic and hypertensive heart disease. Cardiomyopathy is a broad term that includes subacute or chronic disorders of the myocardium. It is also used to refer to a group of systemic diseases and processes that are toxic to or alter the myocardium. Cardiomyopathies are divided into 3 types (ie, dilated, hypertrophic, restrictive). Of these, dilated cardiomyopathy is the most common. See: Emedicine from WebMD

Diuresis: the increased formation of urine by the kidney. Diuresis may be due to a huge number of causes including metabolic conditions such as diabetes mellitus; substances such as coffee, tea, and alcoholic beverages in food and drink; and specific diuretic drugs (i.e., furosemide or Lasix®). See: 

Driveline:  the “cable” attached to the implanted VAD that passes through the skin to connect to the controller.

Dyspnea: difficulty in breathing often associated with lung or heart disease and resulting in shortness of breath; occurs normally during intense physical exertion or at high altitude. Also called air hunger.

Echocardiography: is one of the most important non-invasive techniques used in the diagnosis of heart disease. This technique allows for the visualization of abnormal valve function or contraction of the cardiac walls and can also be used to measure ejection fraction. Echocardiograms are obtained by reflecting high frequency sound waves (ultrasound) off various structures of the heart, then translating the reflected waves into one and two-dimensional images.

Echocardiogram:  an ultrasound of the heart that provides a moving picture of the heart structure, along with information on its function.

Edema:  swelling of soft tissues as a result of excess water accumulation. Edema can occur in almost any location in the body, but the most common sites are the feet and ankles.

Ejection Fraction (EF): the percentage of blood that is pumped out with each heartbeat. This measures the heart’s capacity and functioning ability. Ejection fraction is usually measured in the left ventricle because it is the main pumping chamber of the heart. A normal ejection fraction in a person at rest is typically between 55 and 70 percent. If the heart muscle has been damaged by heart attack, heart muscle disease or heart valve problems, the ejection fraction may be below normal. It is defined by the ratio of stroke volume (SV) to end-diastolic volume (EDV).  EF = SV/EDV. See: WebMD

Electrocardiogram (ECG or EKG):  one of the main tools for the diagnosis of heart diseases, an EKG measures the electrical voltage of the heart.

Electrolyte Levels: refers to sodium, potassium, chloride and other chemical compounds dissolved in the blood.  For the body to function properly, proper blood levels of these chemicals must be maintained. The level of any electrolyte in the blood can become too high or too low. The main electrolytes in the blood are sodium, potassium, calcium, magnesium, chloride, phosphate, and carbonate.

Embolization: the therapeutic introduction of various substances into the circulation to occlude vessels, either to arrest or prevent hemorrhaging, to devitalize a structure, tumor, or organ by occluding its blood supply, or to reduce blood flow to an arteriovenous malformation.

Endocardium: inner layer of the heart muscle.

Endoventricular Thrombus Formation: thrombus formation within the ventricle.

Epicardium: outer layer of the heart muscle.

Exit Site: the location where the driveline passes through the skin.

Extracorporeal BVADS: bi-ventricular assistance devices outside of the body

Extracorporeal Membrane Oxygenator (ECMO): is a special procedure that uses an artificial heart-lung machine to take over the work of the lungs (and sometimes also the heart). ECMO is used most often in newborns and young children, but it also can be used as a last resort for adults whose heart or lungs are failing. ECMO is used for a short period of time (1-2 weeks) in patients with acute ventricular failure.

Extubated: to remove a tube from a hollow organ or passageway, often from the airway. The opposite of extubate is intubate.

Graft: a tube created by using portions of another artery or vein from the patient’s body or synthetic materials to reroute blood around a blockage.

HA5® System: the shortened name for the HeartAssist5® Ventricular Assist System, which comprises the HeartAssist5® VAD, Conquest Controller and Remote Monitoring and the various power sources.

HeartAssist5®: The name of the ReliantHeart VAD.

Heart attack: See: Acute Myocardial Infarction

Heart chambers: the four sections of the heart through which blood is pumped. The two upper chambers are called the left and right atria. The two lower chambers are the left and right ventricles. The right side of the heart receives oxygen-poor blood from the body and pumps it to the lungs. The left side of the heart receives oxygen-rich blood from the lungs and pumps it to the rest of the body. The left ventricle performs 80% of the heart’s work.

Heartbeat: a heartbeat consists of the contraction of the atria, quickly followed by the contraction of the ventricles. The rate of the heartbeat varies according to different levels of activity: the higher the level of activity or emotional excitement, the faster the heart will beat.

Heart Failure: heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. This condition may affect the right side, the left side, or both sides of the heart. As the heart’s pumping action is lost, blood may back up into other areas of the body, including: the liver, the gastrointestinal tract and extremities, and the lungs, Class 4 heart failure is the condition when a patient is exhausted, short of breath or fatigued when just sitting still or lying down in bed.

Heart Failure Cardiologist: a cardiologist or heart specialist whose practice focuses specifically on the treatment of heart failure.

Heart Rate (HR): the number of beats per minute. (avg: 72 beats/min)

Hematocrit: percentage of total blood volume occupied by blood cells. The normal value is 36-49%.

Hemiplegia: a condition where a vertical half of a patient’s body is weak or paralyzed, i.e. one arm and its corresponding leg do not function properly. It can be congenital (occurring before, during, or soon after birth) or acquired (as from illness or stroke). It is usually the result of a stroke, although disease processes affecting the spinal cord and other diseases affecting the hemispheres are equally capable of producing this clinical state. See: Wikipedia

Hemodynamic Insufficiency: inadequate blood flow that results in an inadequate supply of oxygen to all tissues. See:Hemodynamics

Hemoglobin: protein in red blood cells that transports oxygen. The mean range is 14.5-15.5 g/dL.

Hemolysis:  defined as plasma-free hemoglobin of greater than 50mg for more than 12 hours. Associated with systemic hypertension, this condition is usually resolved by reducing the driving pressure in combination with anti-hypertensive agents.

Hemorrhage: bleeding; an escape of the blood through ruptured or unruptured vessel walls.

Hemostasis: the prevention of blood loss; a complex process that changes blood from a fluid to a solid state. Intact blood vessels are central to moderating blood’s tendency to clot. The endothelial cells of intact vessels prevent thrombus formation by secreting tissue plasminogen activator (t-PA) and by inactivating thrombin and adenosine diphosphate (ADP). Injury to vessels overwhelms these protective mechanisms and hemostasis ensues. Hemostasis proceeds in two phases: primary and secondary hemostasis.

Heparin: a highly sulfated glycosaminoglycan widely used as an injectable anticoagulant. Heparin acts via binding to as an anti-thrombin thereby preventing consequent thrombus formation; it also enhances activity of lipoprotein lipases.  It is also used to form an inner anticoagulant surface on various experimental and medical devices such as test tubes and renal dialysis machines. Pharmaceutical grade heparin is commonly derived from the tissue of slaughter house animals, e.g. porcine intestine or bovine lung. See: Wikipedia

Hepatic Function/ Failure: liver function. Fulminant hepatic failure (FHF) is usually defined as the severe impairment of hepatic functions in the absence of preexisting liver disease. See: EMedicine from Web MD

HTx: heart transplantation

Hypercoagulability: refers to the defect of increased clotting and viscosity of blood. Hypercoagulability testing is performed through blood tests. The propensity to develop thrombosis (blood clots) due to an abnormality in the system of coagulation.

Hypertension: the medical term for high blood pressure.

Hypervolemia: an abnormal increase in blood volume or, strictly speaking, an abnormal increase in the volume of blood plasma. See Wikipedia

Hypovolemia: an abnormal decrease in blood volume or, strictly speaking, an abnormal decrease in the volume of blood plasma. Symptoms of hypovolemia may include cold hands and feet, light headedness, infrequent urination, increased heart rate, and weakness. It can lead to hypovolemic shock which can result in multiple organ failure, kidney damage, brain damage, and death.

ICD: an abbreviation for Implantable Cardiac Defibrillator. This is an implanted device that sends small electrical shocks to the heart to stop fast, and potentially deadly, heart rhythms.

Idiopathic Dilated Cardiomyopathy (IDCM): dilation of the right, left or both ventricles with impaired contractility of unknown cause. It is a common form of dilated cardiomyopathy that produces symptoms of heart failure in patients of any age or sex. Overt congestive heart failure may or may not be present.

Impeller: a propulsion device that draws liquid in and forces it through an opening.

Inotropes: inotropes are non-habit-forming medications that strengthen the contractions of the heart. Digoxin is an example.

Inotropic Agents: drugs used to increase the ability of the heart to contract.  Common inotropic drugs are dopamine, dobutamine, epinephrine, milrinone, and norepinephrine. See Wikipedia

Interventional Cardiology: a specialized area of medicine that focuses on diagnostics, treatment and management of patients with cardiovascular disease.

Intraaortic Balloon Pump (IABP): the intraaortic balloon pump (IABP) is a device used in some critically ill people to help the heart pump.  It increases blood flow to coronary arteries and, therefore, the heart muscle, and decreases the workload of the heart through a process called counterpulsation. It can produce up to 20 percent of the workload of the heart. The IABP is placed in the aorta below the level of the aortic arch, which is the main artery that carries oxygen-rich blood to the rest of the body.

Intravenous Lines: the tubing going into the vein in order to administer fluids or medications, or both, into the blood circulation through a vein.

Implantable Pneumatic (IP): the pump is surgically placed inside the body and functions with pulses of air.

Ischemia: reduced blood flow to an organ, usually caused by a constricted or blocked blood vessel.

Ischemic: a decrease in the blood and oxygen supply to an organ or tissue in the body.

Ischemic Cardiomyopathy:  a condition in which an individual has weakened heart pumps, resulting from either previous heart attacks or due to current blockages of the coronary arteries. Blockages in the coronary arteries lead to ischemia, or decreased blood flow to the heart muscle, resulting in decreased oxygen supply to the cells.

LVAD: left ventricular assist device.

LVAD or VAD: an abbreviation for Left Ventricular Assist Device or Ventricular Assist Device. This is the mechanical pump that is implanted in the left ventricle of the heart.

LVAS: left ventricle assist system which includes the LVAD (blood pump), drive line, system controller, batteries, PBU and display module.

LVAS or VAS:  an abbreviation for Left Ventricular Assist System or Ventricular Assist System. This comprises the mechanical pump (LVAD), the controller, and each of the power sources (batteries, AC adapter, and DC adapter).

Left Atrium: receives oxygen enriched blood from the lungs and passes it on to the left ventricle.

Left Ventricle: one of the two bottom chambers in the human heart. It receives oxygenated blood from the left atrium via the mitral valve, and pumps it into the aorta via the aortic valve. It forms a small part of the sternocostal surface and a considerable part of the diaphragmatic surface of the heart; it also forms the apex of the heart. See: Wikipedia

Left-Ventricular Assist Device (LVAD): a mechanical pump that is surgically implanted and is used to aid the natural pumping action of the heart’s left ventricle. This device is sometimes called a “bridge to transplant” because it buys time until a heart transplant can be performed. See: ReliantHeart.

Left Ventricular Assist System: a class of medical devices that helps the left side of the heart pump oxygen-rich blood through the body. Also called a Left Ventricular Assist Device.

Magnetic Levitation: through electromagnetics and position sensors, the impeller is suspended within the blood chamber.

Massive Myocardial Infarction: infarction of the myocardium that results typically from coronary occlusion, that may be marked by sudden chest pain, shortness of breath, nausea, and loss of consciousness, and that sometimes results in death.

Mechanical circulatory support (MCS) a way of improving blood flow using a ventricular assist device (VAD), which is an implantable, electrically powered heart pump that works to improve blood flow in cooperation with the heart. MCS is used either as Bridge-to-Transplantation therapy for heart failure patients awaiting heart transplant, or as Destination Therapy for patients ineligible for heart transplant. Additional uses include Post-Cardiotomy Recovery, for patients who are unable to wean from cardiopulmonary bypass, and short-term support for patients at risk of shock from acute heart failure while longer-term treatment decisions are being made.

Mediastinal Infections: acute bacterial infection of the mediastinum. Such infections can evoke a devastating disease which, in its fulminating form, is often unresponsive to the best therapeutic efforts. However, if mediastinitis is diagnosed before it reaches the morbid pathological state, appropriate antibiotic therapy and well-planned surgical intervention may favorably alter the prognosis. See: Wikipedia

Mitral Valve: bicuspid valve, left atrioventricular valve: a valve in the heart located in the opening between the left atrium and the left ventricle, prevents the blood in the ventricle from returning to the atrium, and consists of two triangular flaps attached at their bases to the fibrous ring which surrounds the opening and connected at their margins with the ventricular walls by the chordae tendineae and papillary muscles.

Myocardial Infarction: damage or death of myocardial tissue (heart muscle) due to reduced or no blood flow to the area. Commonly known as a “heart attack”.

Myocardial Revascularization: restoring blood flow to the myocardium (heart muscle).

Myocarditis: inflammation of the heart muscle brought on by a virus or bacteria, which may even result from allergic reaction.

Myocardium:  the middle muscular layer of the heart wall. The myocardium is responsible for the heart’s pumping action and contracts to pump blood out of the heart, and then relaxes as the heart refills with returning blood. The myocardium is the layer that has the largest oxygen need and is most affected by decreased blood flow (ischemia). See: Wikipedia

New York Heart Association (NYHA): a functional classification system that physicians use to assess the stage of heart failure and best course of therapy. This system relates symptoms to everyday activities and the patient’s quality of life. See: Heart Failure Society of America 

NYHA Class IV Heart Failure: end stage heart failure in which an individual is unable to carry out any physical activity without discomfort.  Symptoms of cardiac insufficiency at rest. If any physical activity is undertaken, discomfort is increased. See: American Heart Association

Occlusion: venous or arterial occlusion is a state of being closed or shut.

Open Heart Centers: hospitals that perform open heart surgery such as valve repair or replacement, coronary artery bypass, or any other non-transplant procedure.

Organ Perfusion: an act or instance of perfusing; specifically, the pumping of a fluid through an organ or tissue believes that intermittent injection is better and safer than continuous perfusion. See: Year Book of Urology.

Orthotopic Implantation: of or relating to the grafting of tissue or organ into its natural position within the body (orthotopic transplant.)

Orthotopic Pneumatic Device: any of various tools and instruments that are grafted to tissue in the correct position and generate and utilize compressed air.  See: CardioWest artificial heart

Pacemaker: a small implanted device that sends electri­cal signals to the heart via electrodes to cause the heart to contract. This device is intended to maintain a regular heartbeat.

Paracorporeal: literally, “outside the body;” describes the location of the PVAD, which is positioned on top of the abdomen.

Patient Pack:  worn around a patient’s waist or shoulder, this pack contains the VAD peripherals, such as the batteries and controller – enabling VAD patients to maintain a mobile lifestyle

Percutaneous: passed through the skin.

Perfusion: blood flow.

Perfusion Pressure: the difference between the arterial and venous pressures through an organ or capillary bed.

Perfusion Scan: a test to determine blood flow through the vessels to the heart.

Pericardial Cavity: the potential space formed between the two layers of serous pericardium around the heart. Normally, it contains a small amount of serous fluid that acts to reduce surface tension and lubricate. Therefore, the cavity facilitates the free movement of the heart. The cavity surrounds the heart and is continuous with it at all but the points of entry and exit of great vessels.

Pericardial Placement:  the ability to locate the VAD in the double-walled sac that contains the heart; negating the need to create a more invasive pump pocket within the abdomen to hold the VAD.

Pericardium: the thin outer covering sac (membrane) that surrounds the heart and the roots of the great blood vessels. See: Wikipedia

Plasma: the liquid portion of the blood. See: Wikipedia

Plasmin: proteolytic enzyme that decomposes fibrin and other clotting factors and dissolves blood clots.

Platelet Count: a diagnostic test that determines the number of platelets in the patient’s blood. There are normally between 150,000-450,000 platelets in each microliter of blood. Low platelet counts or abnormally shaped platelets may be associated with bleeding disorders. High platelet counts sometimes indicate disorders of the bone marrow.

Platelets: also called thrombocytes, are small disk-shaped blood cells produced in the bone marrow and involved in the process of blood clotting. See: Wikipedia

Pneumothorax: a condition in which air gets between the lungs and the chest wall. Pneumothorax is one cause of a collapsed lung — a serious, sometimes life-threatening, condition.

Post Cardiotomy Cardiogenic Shock (PCCS): cardiogenic shock that takes place during open heart surgery, often as a result the patient cannot come off heart-lung support machine.

Post-Cardiotomy Recovery: mechanical circulatory support for patients who are unable to wean from cardiopulmonary bypass.

Pulmonary Artery:  the artery which carries blood away from the heart and extends from the right ventricle and branches into left and right pulmonary arteries. The left and right pulmonary arteries extend to the left lung and right lung, and deliver deoxygenated blood to the corresponding lung. See: Wikipedia

Pulmonary Edema: a condition which involves fluid accumulation and swelling in the lungs. Pulmonary edema is usually caused by heart failure that results in increased pressure in the pulmonary (lung) veins. However, problems within the lungs themselves can also result in fluid accumulation. Pulmonary edema can be a complication of a heart attack, leaking or narrowed heart valves (mitral or aortic valves), or any disease of the heart that either results in weakening and/or stiffening of the heart muscle (cardiomyopathy). Pulmonary edema can also be caused by direct lung injury from toxins including heat and poisonous gas, severe infection, or an excess of body fluid as seen in kidney failure. See: Mayo Clinic

Pulmonary Hypertension (PHT): high blood pressure in the arteries that supply the lungs.

Pulmonary Valve: heart valve between right ventricle and pulmonary artery.

Pulse Pressure: the difference between systolic and diastolic pressures.

Pump: a common alternate name for a LVAD or VAD.

PVAD:  Paracorporeal Ventricular Assist Device.

Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH ): a randomized study sponsored by the National Heart, Lung and Blood Institute (NHLBI) that evaluated LVADs as long-term destination therapy. Compared with previous trials, REMATCH enrolled patients with far more advanced heart failure. Although investigators had hoped to further optimize standard therapy, nearly all patients randomized to medical therapy (the non-LVAD group) were already receiving optimal medical management (OMM).

Renal Function/ Failure: an indication of the state of the kidney and its role in physiology.  Renal failure is characterized by the loss of the ability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes. See: Wikipedia

Right Atrium: receives oxygen depleted blood from the body and passes it on to the right ventricle.

Right Heart Failure: heart failure caused by damage to the heart’s right-sided chambers. This usually occurs as a result of left-sided heart failure. When the left ventricle fails, increased fluid pressure is, in effect, transferred back through the lungs, ultimately damaging the heart’s right side. When the right side loses pumping power, blood backs up in the body’s veins. This usually causes swelling in the legs and ankles.

Right Ventricle:  one of the two bottom chambers in the human heart. The right ventricle receives de-oxygenated blood as the right atrium contracts. The pulmonary valve leading into the pulmonary artery is closed, allowing the ventricle to fill with blood. Once the ventricles are full, they contract. As the right ventricle contracts, the tricuspid valve closes and the pulmonary valve opens. The closure of the tricuspid valve prevents blood from backing into the right atrium and the opening of the pulmonary valve allows the blood to flow into the pulmonary artery toward the lungs. See: Wikipedia

Risk factors: the list of activities or health habits that contribute to, or cause, heart failure, including drinking alcohol, diabetes, smoking, poor diet, lack of exercise, stress, salt intake and obesity, or family history. The impact of these factors may be reduced by making appropriate lifestyle changes.

RVAD: right ventricular assist device.

Seizure (Convulsions): are temporary abnormal electrophysiologic phenomena of the brain resulting in abnormal synchronization of electrical neuronal activity. They can manifest as an alteration in mental state, tonic or clonic movements and various other symptoms. They are due to temporary abnormal electrical activity of a group of brain cells. See: Wikipedia

Semilunar Valves: general name for valves between the right ventricle and pulmonary artery and left ventricle and aorta.

Sepsis: a toxic condition resulting from the spread of bacteria or their products from a focus of infection. The immunological response that causes sepsis is a systemic inflammatory response causing widespread activation of inflammation and coagulation pathways. This may progress to dysfunction of the circulatory system and, even under optimal treatment, may result in the multiple organ dysfunction syndrome and eventually death.  See: Wikipedia

Shower Bag: a water-resistant carrying case for your controller and batteries while showering.

Sputum:  matter that is coughed up from the respiratory tract, such as mucus or phlegm, mixed with saliva.  In heart failure patients, sputum may be pink or blood-tinged.

Stenosis: a narrowing or constriction of the diameter of a bodily passage or orifice.  Aortic stenosis is the narrowing or obstruction of the heart’s aortic valve, which prevents it from opening properly and blocks the flow of blood from the left ventricle to the aorta. See: MedLine Plus Medical Encyclopedia: Aortic Stenosis

Sternotomy: a type of incision in the center of the chest, that separates the sternum (chestbone) to allow access to the heart. See: University of Southern California

Stroke: the sudden death of a portion of the brain cells due to a lack of oxygen. A stroke occurs when blood flow to the brain is damage resulting in abnormal function of brain. It is caused by blockage or rupture of an artery to the brain.

Stroke Volume (SV): the blood volume ejected by each ventricle with each beat.  SV= CO/HR

Surgical Revascularization: the process of restoring the functionality of an affected organ. It involves a thorough analysis and diagnosis and treatment of the existing diseased vasculature of the affected organ, and can be aided by the use of different imaging modalities such as magnetic resonance imaging, pet scan, CT scan, and X ray fluoroscopy. See: Wikipedia

Syncope: a temporary loss of consciousness usually related to temporary insufficient blood flow to the brain — a fainting spell. It may be caused by many different factors including emotional stress, pooling of blood in the legs due to sudden changes in body position, or heavy sweating. Syncope may occur during violent coughing spells (especially in men) because of rapid changes in blood pressure. It also may result from a number of heart and lung disorders.

Systole: the period of ventricular contraction and blood ejection.  See Human Physiology, Vander et al. McGraw Hill, 6th ed. 1994.

Systolic Pressure: the maximum pressure reached during peak ventricular ejection.  It is heard as the pressure of blood against the artery walls when the heart has just finished contracting or pumping out blood. It is the upper number of a blood pressure reading. See: WebMD

Tachycardia:  an abnormally rapid heartbeat, defined as a resting heart rate of 100 or more beats per minute in an average adult. It can have harmful effects in two ways. First, when the heart beats too rapidly, it is unable to fill correctly and performs less efficiently. Second, it increases the work of the heart, causing it to require more oxygen.

Temporary Total Artificial Heart (TAH-t): a mechanical device that replaces the normal heart orthotopically and assumes its functions.

Thoracic Cavity: the space within the walls of the chest, bounded below by the diaphragm and above by the neck, and containing the heart and the lungs. See:

Thromboembolism: occurs when red blood cells, fibrin, platelets and leukocytes form a mass or thrombus within an intact cardiovascular system.  An embolism occurs when a segment of a thrombus within the cardiovascular system detaches from the vessel, travels within the body and lodges within another, smaller vein or artery.

Thrombus: a blood clot in a blood vessel or within the heart. See: MedlinePlus

Transient Ischemic Attacks (TIA): a “mini-stroke” caused by temporary disturbance of blood supply to an area of the brain, resulting in a sudden, brief decrease in brain function. (It lasts less than 24 hours, usually less than one hour). See: Medicine Plus

Transplant Center: hospitals that perform heart transplants. About 2,200 transplants are performed each year at approximately 100 centers in the U.S.

Tricuspid Valve (right atrioventricular valve): a valve that is situated at the opening of the right atrium of the heart into the right ventricle and consists of three triangular membranous flaps.

VAD a ventricular assist device (VAD) is a heart pump designed to help restore proper pumping function to a weakened or damaged heart through a process called mechanical circulatory support (MCS). It works to improve blood flow in cooperation with your heart, but does not replace your own heart.

VAD Center a medical center trained and equipped to implant ventricular assist devices (VADs) for the treatment of advanced heart failure. The VAD team consists of the VAD coordinator, cardiologist, cardiothoracic surgeon, operating room and nursing staff.

Valves: flap-like structures in the heart that open and close to let the blood flow in only one direction. The four heart valves are: the tricuspid, the pulmonary or pulmonic (in the right side of the heart), the mitral and the aortic valve (in the left side).

Valvular Regurgitation: the presence of backwards, or retrograde, flow across a given closed cardiac valve.

Vasodilators: agents that open vessels by relaxing their muscular walls. For example, nitroglycerin is a vasodilator.

VE – Vented Electric: the implanted pump contains an electric motor but is vented to outside air through the driveline.

Ventricular Assist Device (VAD): mechanical device that is used to partially or completely replace the function of a failing heart. The devices are generally designed to replace or assist cardiac function temporarily, but recently devices are becoming available that can be implanted permanently for so called “destination therapy”. Most patients using the devices, however, are awaiting heart transplant. See: Wikipedia

Ventricular Septal Defect (VSD): a defect between the two lower chambers (the ventricles) of the heart.

Ventricular Clot: a clot within a ventricle.

Ventricular Fibrillation: an often fatal form of arrhythmia characterized by rapid, irregular fibrillar twitching of the ventricles of the heart in place of normal contractions, resulting in a loss of pulse and death. See:

Ventricular Tachycardia: a rapid heartbeat initiated within the ventricles, characterized by 3 or more consecutive premature ventricular beats. It is a potentially lethal disruption of normal heartbeat (arrhythmia) that may cause the heart to become unable to pump adequate blood through the body. The heart rate may be 160 to 240 (normal is 60 to 100 beats per minute). It can occur in the absence of apparent heart disease. It can also develop as an early or a late complication of a heart attack, or during the course of cardiomyopathy, valvular heart disease, myocarditis, and following heart surgery. See: MedlinePlus Medical Encyclopedia

Ventricular Thrombus: a fibrinous clot formed in the ventricle of the heart.

Warfarin (Coumadin®): an anticoagulant with the same actions as dicumarol; also used as a rodenticide; also available as the potassium salt, with the same actions and uses.  An anticoagulant medicine that decreases the ability of blood to form clots.  Blood clots can occur in the veins of the lower extremities, usually after periods of immobility. These clots can break off and become lodged in the blood vessels of the lung (pulmonary embolism), causing shortness of breath, chest pain, and even life-threatening shock. Blood clots can also occur in the atria of the heart during atrial fibrillation, and around artificial heart valves. One of these clots can also break off and obstruct a blood vessel in the brain, causing an embolic stroke with paralysis. Coumadin is important in preventing the formation of blood clots. It is also important to prevent extension of clots already formed, and to minimize the risk of blood clot embolization to other vital organs such as the lungs and brain. See:

White Blood Cell Count: a test which determines the number of white blood cells and the percentage of each type of white blood cell in a person’s blood. These tests are included in general health examinations and help investigate a variety of illnesses, including infection, allergy, and leukemia.


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