Introduction

The overarching goal in medicine is to do the right thing for the right patient at the right time. A thorough understanding and application of physiology and pathophysiology and advanced monitoring is essential to accomplishing this goal. Nowhere is this more evident than in the practice of cardiac critical care medicine. We utilize the ventricular pressure–volume relationship and time-varying elastance model to provide a foundation for understanding cardiovascular physiology and pathophysiology, the interpretation and limitations of standard and advanced hemodynamic monitoring, and the physiologic basis and hemodynamic effects of therapeutic interventions. We build on this foundation by utilizing a cardiovascular simulator to illustrate the application of these important principles in the care of patients with critical cardiac disease.