How to diagnose and manage emergency medical conditions in patients on left ventricular assist device support: A clinician's field guide

Left ventricular assist devices (LVADs) have revolutionized the treatment of advanced heart failure, providing mechanical circulatory support for patients awaiting heart transplantation or as destination therapy. However, patients on LVAD support are susceptible to a range of emergency medical conditions that require prompt recognition, intervention, and multidisciplinary management. This review paper aims to provide an algorithmic approach and a field guide on the diagnosis and management of emergency medical conditions in LVAD patients, including LVAD alarms, gastrointestinal bleeding, cerebrovascular accidents, pump thrombosis and obstruction, unresponsiveness, and electrical shock by the defibrillator. By understanding the mechanisms, clinical presentation, diagnostic evaluation, and therapeutic strategies associated with these conditions, healthcare providers can improve patient outcomes and optimize LVAD care.