LVAD patients are increasingly encountered in emergency rooms and ICUs, yet many clinicians remain uncertain about initial management.

A recent JACC State-of-the-Art Review provides a practical framework for recognizing and treating LVAD emergencies, from pump thrombosis and right-heart failure to arrhythmias and GI bleeding.

Key pearls:

• LVAD patients may lack a palpable pulse,
• Doppler is preferred for MAP measurement, and
• Chest compressions should not be delayed if cardiac arrest is confirmed.
• First check power connection
• Understanding pump parameters and echocardiographic clues can rapidly guide diagnosis and life-saving therapy.