{"id":9183,"date":"2025-11-12T12:50:20","date_gmt":"2025-11-12T09:50:20","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=9183"},"modified":"2025-11-12T12:50:20","modified_gmt":"2025-11-12T09:50:20","slug":"national-jcs-heart-failure-protocols-2025","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/national-jcs-heart-failure-protocols-2025\/","title":{"rendered":"National JCS Heart Failure Protocols – (2025)"},"content":{"rendered":"
National JCS Heart Failure Protocols – (2025)<\/div>\n
<\/div>\n
Acute Heart Failure \u2013 Emergency and Early In-Hospital Management<\/div>\n
<\/div>\n
“Developed by the Jordan Cardiac Society (JCS) Heart Failure National Task Force”<\/div>\n
(Adapted from ESC 2021\u20132024 \/ 2023 updates, AHA\u2013ACC\u2013HFSA 2022\u20132025, NICE 2025, AHA\u2013ACLS 2025)<\/div>\n
<\/div>\n
<\/div>\n
1. Rapid Recognition and Initial Assessment<\/div>\n
<\/div>\n
* Initial assessment must be clinical and concurrent with vital signs stabilization (airway, breathing, circulation).<\/div>\n
<\/div>\n
* Any patient presenting with acute dyspnea, orthopnea, or pulmonary rales should be considered as possible AHF or acute pulmonary edema until proven otherwise.<\/div>\n
<\/div>\n
Key bedside findings:<\/div>\n
* Agitation and shortness of breath (SOB)<\/div>\n
* Diaphoresis (sweating and distress)<\/div>\n
* Tachypnea and tachycardia<\/div>\n
* Blood pressure (BP): may be elevated in hypertensive AHF, normal in most cases, or low in cardiogenic shock<\/div>\n
<\/div>\n
Immediate actions:<\/div>\n
* Ensure ABCs and start continuous SpO\u2082 and BP monitoring.<\/div>\n
* Perform ECG, chest X-ray, and bedside echocardiography (PoCUS\/focused echo).<\/div>\n
* Order BNP or NT-proBNP, troponin, creatinine\/electrolytes, and CBC.<\/div>\n
<\/div>\n
Interpretation:<\/div>\n
* NT-proBNP < 300 pg\/mL \u2192 AHF unlikely.<\/div>\n
* Elevated troponin suggests myocardial strain or ischemia but is not diagnostic alone.<\/div>\n
* Always integrate lab results with clinical and imaging findings.<\/div>\n
<\/div>\n
Diagnostic support tool :<\/div>\n
PRIDE Score: combines NT-proBNP (2 points if above age-adjusted cutoff) with clinical and radiographic findings (1 point each for history of HF\/CAD, orthopnea, rales, edema, and chest congestion).<\/div>\n
* High probability: \u2265 6 points \u2192 supports acute HF.<\/div>\n
* Low probability: < 4 points \u2192 HF unlikely.<\/div>\n
<\/div>\n
2. Early Clinical Presentation for Initial Management in the Emergency Department<\/div>\n
<\/div>\n
* The clinical presentation reflects the initial hemodynamic profile \u2014 congested (wet), hypoperfused (cold), or both.<\/div>\n
* Identifying the profile early directs therapy:<\/div>\n
\u2013 Wet\/warm: diuretics \u00b1 vasodilators.<\/div>\n
\u2013 Cold\/wet: inotropes or vasopressors; avoid vasodilators.<\/div>\n
\u2013 Dry\/warm: compensated; review chronic therapy.<\/div>\n
* In most cases, congestion predominates, similar to acute pulmonary edema, where SBP dictates treatment sequence:<\/div>\n
\u2013 High BP : vasodilator first, diuretic after oxygenation improves.<\/div>\n
\u2013 Normal BP (100\u2013140 mmHg): diuretic first, add vasodilator if BP stable and congestion persists.<\/div>\n
\u2013 Low BP (< 100 mmHg): avoid vasodilators; initiate inotropes\/pressors.<\/div>\n
* Common presentations:<\/div>\n
\u2013 Acute on chronic HF (ADHF) \u2013 60\u201370 % of admissions.<\/div>\n
\u2013 Flash pulmonary edema \u2013 rapid onset, high BP, severe dyspnea.<\/div>\n
\u2013 Isolated RV failure \u2013 JVP distension, ascites, hepatomegaly.<\/div>\n
\u2013 Cardiogenic shock \u2013 \u201ccold & wet\u201d: hypotension, congestion, end-organ hypoperfusion.<\/div>\n
<\/div>\n
3. Hemodynamic Management in AHF<\/div>\n
<\/div>\n
Refers to adjusting therapy according to blood pressure and congestion, using diuretics, vasodilators, inotropes, or vasopressors as indicated.<\/div>\n
The management of congestion follows the same principles as acute pulmonary edema, where SBP determines therapy priority.<\/div>\n
<\/div>\n
A. Timing, Monitoring, and Sequential Use of Diuretics and Vasodilators<\/div>\n
* Loop diuretics are the first-line therapy for congested, normotensive AHF.<\/div>\n
* Onset: 5\u201315 min; peak effect: \u2248 2 h.<\/div>\n
* Monitor and guide therapy from the start and throughout the first 2 hours:<\/div>\n
\u2013 Begin immediate clinical and hemodynamic observation once IV loop diuretics are given.<\/div>\n
Track symptoms, respiratory effort, and overall clinical progression continuously, along with vital signs (BP, HR, SpO\u2082, urine output) and physical findings (dyspnea, crackles, jugular venous pressure, peripheral edema, mental status).<\/div>\n
\u2013 Adjust treatment dynamically according to the patient\u2019s condition:<\/div>\n
* If marked pulmonary congestion or severe respiratory distress persists and SBP \u2265 110 mmHg, initiate a vasodilator concurrently with the loop diuretic for faster relief.<\/div>\n
* If IV nitroglycerin is not yet available, a sublingual nitrate (Isojey SL 5 mg) may be given as an emergency bridge, provided SBP \u2265 110 mmHg and no evidence of RV infarction or hypotension.<\/div>\n
* Once possible, switch to IV nitroglycerin 5\u201310 \u00b5g\/min, titrating every 3\u20135 minutes while checking BP frequently.<\/div>\n
\u2013 Continue close reassessment during the first two hours, noting changes in dyspnea, oxygenation, urine output, and blood pressure to decide whether to intensify diuretics, continue combination therapy, or withhold vasodilators if SBP falls below 100 mmHg or perfusion worsens.<\/div>\n
* Avoid vasodilators early or if SBP < 100 mmHg.<\/div>\n
<\/div>\n
B. Vasodilator Therapy (SBP \u2265 90 mmHg)<\/div>\n
* Use only if congestion present and BP allows safe reduction (preferably > 100 mmHg).<\/div>\n
* Add after or with diuretics if symptoms persist and BP stable.<\/div>\n
* IV nitroglycerin: start 5\u201310 \u00b5g\/min \u2192 titrate every 3\u20135 min up to 200 \u00b5g\/min.<\/div>\n
* \u2022 In hypertensive AHF or acute pulmonary edema, initiate intravenous nitroglycerin at 5\u201310 \u00b5g\/min and titrate rapidly every 3\u20135 minutes by 5\u201320 \u00b5g\/min increments (or by doubling the rate if tolerated) until clinical improvement and a 20\u201325 % reduction in systolic BP are achieved, while maintaining SBP > 100 mmHg.<\/div>\n
* Continuous monitoring required.<\/div>\n
* Avoid: SBP < 100 mmHg, cardiogenic shock, or RV infarction.<\/div>\n
<\/div>\n
C. Hypoperfusion or \u201cCold\u201d States<\/div>\n
* Norepinephrine: start at 0.05 \u00b5g\/kg\/min, titrate to maintain MAP \u2265 65 mmHg (\u2248 SBP \u2265 90\u2013100 mmHg).<\/div>\n
* If signs of hypoperfusion persist despite achieving adequate MAP \u2014 such as cold extremities, oliguria, altered mentation, narrow pulse pressure, or elevated lactate \u2014 add one inotrope (dobutamine or milrinone) to improve contractility and systemic perfusion.<\/div>\n
<\/div>\n
\u2022\u00a0 Dobutamine:<\/div>\n
\u2013 Start: 2\u20135 \u00b5g\/kg\/min.<\/div>\n
\u2013 Titrate: gradually up to 10 \u00b5g\/kg\/min (may reach 20 \u00b5g\/kg\/min in ICU with invasive monitoring).<\/div>\n
\u2013 Effective range for most patients: 2\u201310 \u00b5g\/kg\/min.<\/div>\n
Titration goals and monitoring:<\/div>\n
* Increase cardiac output and systemic perfusion (target MAP \u2265 65 mmHg).<\/div>\n
* Monitor for tachycardia or arrhythmia \u2014 reduce the dose if HR > 120\u2013130 bpm or ectopy develops.<\/div>\n
* Continuous ECG and BP monitoring are recommended.<\/div>\n
* Dopamine only if hypotension with bradycardia, under invasive monitoring.<\/div>\n
<\/div>\n
4. Supportive and Preventive Measures<\/div>\n
* Oxygen: only if SpO\u2082 < 90 % (target > 92 %; in known COPD, target 88\u201392 %).<\/div>\n
* Non-Invasive Ventilation (NIV) (CPAP\/BiPAP): for persistent hypoxemia or RR > 25\/min; decreases preload and afterload.<\/div>\n
<\/div>\n
5. Venous Thromboembolism (VTE) Prophylaxis<\/div>\n
* Hospitalized AHF patients are at high risk due to immobility and venous congestion.<\/div>\n
* Balance VTE risk (IMPROVE-VTE) vs bleeding risk (IMPROVE-Bleed).<\/div>\n
<\/div>\n
IMPROVE-VTE (Thrombosis Risk):<\/div>\n
* HF\/respiratory failure, cancer, immobility > 7 days (3 pts), previous VTE (3 pts), age \u2265 60, elevated D-dimer.<\/div>\n
* \u2265 4 = high risk \u2192 LMWH 40 mg SC daily or UFH 5000 U SC q8\u201312 h.<\/div>\n
<\/div>\n
IMPROVE-Bleed (Bleeding Risk):<\/div>\n
* Prior major bleed (4), platelets < 50 000 (4), CrCl < 30 (2.5), liver failure (2.5), active cancer (2), age \u2265 85 (3.5), central line\/ICU\/rheumatic disease (1\u20132).<\/div>\n
* \u2265 7 = high risk \u2192 avoid or shorten pharmacologic prophylaxis.<\/div>\n
<\/div>\n
Combined Approach:<\/div>\n
* VTE \u2265 4 & Bleed < 7 \u2192 start pharmacologic prophylaxis.<\/div>\n
* VTE < 4 or Bleed \u2265 7 \u2192 mechanical methods only.<\/div>\n
* Reassess both scores every 48\u201372 h or when clinical status changes.<\/div>\n
<\/div>\n
6. Pre-Discharge and Transition of Care<\/div>\n
<\/div>\n
* Confirm complete decongestion, stable weight, optimized oral diuretics.<\/div>\n
* SBP > 100 mmHg, SaO\u2082 > 92 %.<\/div>\n
* Review renal\/electrolyte balance.<\/div>\n
* Arrange follow-up within 7\u201314 days with GDMT titration plan and rehab referral.<\/div>\n
<\/div>\n
7. Discharge Readiness and Risk Tools<\/div>\n
* Safe discharge: improved symptoms, SBP > 100, HR < 90, RR < 20, stable biomarkers, no ischemia\/arrhythmia, adequate social support, and early follow-up.<\/div>\n
<\/div>\n
HEARTRISK6 \u2013 Tool for ED Disposition<\/div>\n
(final ED decision \u2013 admit ,or discharge) from ER:<\/div>\n
* Determines need for admission vs safe discharge.<\/div>\n
* Components:<\/div>\n
\u2013 H: valvular heart disease<\/div>\n
\u2013 E: elevated HR after stabilization<\/div>\n
\u2013 A: early need for NIV (CPAP\/BiPAP)<\/div>\n
\u2013 R: raised creatinine (\u2191Cr)<\/div>\n
\u2013 T: troponin elevation<\/div>\n
\u2013 \u201c6\u201d: abnormal post-treatment vitals (tachycardia, hypotension, desaturation)<\/div>\n
* Score \u2265 3 \u2192 admit; < 3 \u2192 consider discharge if stable and follow-up secured.<\/div>\n
<\/div>\n
8. Advanced and Rescue Therapies<\/div>\n
<\/div>\n
* Cardiogenic shock unresponsive to drugs \u2192 escalate to MCS (IABP, Impella, or VA-ECMO).<\/div>\n
* Apply Door-to-ECMO concept \u2013 each minute saved improves neurologic survival in ECPR.<\/div>\n
* Proposal: establish a national CPR-ECMO Center (JCS + MoH) for standardized simulation and training.<\/div>\n
<\/div>\n
<\/div>\n
National JCS Heart Failure Protocols \u2013 Framework (2025)<\/div>\n
<\/div>\n
Developed by the Jordan Cardiac Society (JCS) Heart Failure National Task Force<\/div>\n
(Adapted from ESC 2021\u20132024 \/ 2023 updates, AHA\/ACC\/HFSA 2022\u20132025, NICE 2025, AHA\/ACLS 2025)<\/div>\n
<\/div>\n
A) Acute Heart Failure \u2013 Emergency and Early In-Hospital Management<\/div>\n
<\/div>\n
1. Rapid Recognition and Initial Assessment<\/div>\n
\u2022 Treat any patient with sudden severe dyspnea, crackles, orthopnea, or pink frothy sputum as acute HF or pulmonary edema until proven otherwise.<\/span><\/div>\n
\u2022 Key bedside observations: upright sitting posture, agitation, tachypnea, tachycardia, elevated BP, history of HF, CAD, or hypertension.<\/span><\/div>\n
\u2022 Early differential includes bronchospasm (asthma\/COPD), PE, pneumonia, tamponade, and acute valvular failure.<\/span><\/div>\n
\u2022 Immediate investigations:<\/span><\/div>\n
\u2022 ECG, chest X-ray, echocardiography (PoCUS or full echo), BNP \/ NT-proBNP, troponin, creatinine\/electrolytes, CBC.<\/span><\/div>\n
\u2022 BNP rule-out thresholds: NT-proBNP < 300 pg\/mL (acute) \u2192 HF unlikely.<\/span><\/div>\n
\u2022 Use PRIDE score or similar when diagnosis uncertain.<\/span><\/div>\n
<\/div>\n
2. Clinical Phenotyping (ED Profiles)<\/div>\n
1. Acute on top of chronic HF<\/span><\/div>\n
(Acute Decompensated Heart Failure)<\/div>\n
= acute worsening of chronic heart failure, accounting for about 60\u201370% of HF hospital admissions.<\/div>\n
Common triggers include volume or sodium overload, uncontrolled hypertension, myocardial ischemia, arrhythmia, infection, renal dysfunction or acute kidney injury, thyroid disorders, anemia, pulmonary embolism, and poor medication adherence.<\/div>\n
2. Flash Pulmonary Edema \u2013 rapid hypoxemia, often hypertensive.<\/span><\/div>\n
3. Isolated Right-Ventricular Failure \u2013 jugular distension, ascites, hepatic congestion, often without lung crackles.<\/span><\/div>\n
4. Cardiogenic Shock \u2013 The most severe form of acute heart failure \u2014 marked by pulmonary congestion (wet) and poor perfusion (cold) due to low cardiac output hypotension + hypoperfusion (cold\/clammy, oliguria, confusion).<\/span><\/div>\n
<\/div>\n
3. Hemodynamic Management<\/div>\n
<\/div>\n
A. Congested or \u201cWet\u201d States<\/div>\n
\u2022 IV loop diuretics: first-line; if on oral, give 1\u20132\u00d7 home dose IV.<\/span><\/div>\n
\u2022 Check response at 2 h: urine > 100\u2013150 mL\/h or urine Na\u207a > 50\u201370 mmol\/L.<\/span><\/div>\n
\u2022 If poor response \u2192 double dose or add thiazide\/acetazolamide.<\/span><\/div>\n
\u2022 For refractory cases \u2192 consider ultrafiltration.<\/span><\/div>\n
<\/div>\n
B. Vasodilators (SBP \u2265 90 mmHg)<\/div>\n
\u2022 IV nitroglycerin: start 5\u201310 \u00b5g\/min \u2192 titrate q3\u20135 min (up to 200 \u00b5g\/min).<\/span><\/div>\n
\u2022 High-dose strategy beneficial in hypertensive flash pulmonary edema : Titrate every 3\u20135 minutes by 10\u201320 \u00b5g\/min increments until symptoms improve or SBP decreases by about 25 %, keeping SBP > 100 mmHg.<\/span><\/div>\n
\u2022 Avoid vasodilators in hypotension or suspected RV infarction.<\/span><\/div>\n
<\/div>\n
C. Hypoperfusion or \u201cCold\u201d States<\/div>\n
\u2022 Norepinephrine 0.05 \u00b5g\/kg\/min \u2192 titrate to MAP \u2265 65 ( mmHg(MAP \u2265 65 mmHg roughly corresponds to SBP \u2265 90\u2013100 mmHg, which serves as a quick clinical reference for adequate organ perfusion in emergency settings.)<\/span><\/div>\n
\u2022 If low output persists (cold skin, low urine, confusion) despite adequate MAP, combine norepinephrine with one inotrope (dobutamine or milrinone) \u2014 but never use two inotropes together routinely.: give one inotrope \u2014 dobutamine (2\u201310 \u00b5g\/kg\/min).<\/span><\/div>\n
<\/div>\n
Dopamine is no longer recommended as a routine inotrope for cardiogenic shock or low-output heart failure.<\/div>\n
It should be used only in patients with hypotension accompanied by bradycardia, and always under close hemodynamic monitoring (AHA \/ ESC \/ SCAI 2023\u20132025).<\/div>\n
\u2022 Continuous arterial and central venous monitoring recommended if available.<\/span><\/div>\n
\u2022 Do not combine two inotropes except in refractory ICU cases.<\/span><\/div>\n
<\/div>\n
4. Supportive & Preventive Measures<\/div>\n
\u2022 Oxygen: only if SpO\u2082 < 90 % (target > 92 %).<\/span><\/div>\n
\u2022 Non-invasive ventilation (CPAP\/BiPAP): for persistent hypoxemia or RR > 25 \/min; improves preload & afterload.<\/span><\/div>\n
<\/div>\n
* VTE prophylaxis: guided by IMPROVE-VTE (\u2265 4 = high risk) and IMPROVE-Bleed (\u2265 7 = high bleeding risk).<\/div>\n
\u2003\u2022 IMPROVE-VTE (for clot risk) \u2013 each 1 pt unless noted:<\/div>\n
\u2003\u2003\u2022 Heart or respiratory failure<\/div>\n
\u2003\u2003\u2022 Cancer<\/div>\n
\u2003\u2003\u2022 Immobility > 7 days (3 pts)<\/div>\n
\u2003\u2003\u2022 Previous VTE (3 pts)<\/div>\n
\u2003\u2003\u2022 Age \u2265 60 y<\/div>\n
\u2003\u2003\u2022 Elevated D-dimer<\/div>\n
\u2003\u2192 \u2265 4 pts = high VTE risk \u2192 give prophylaxis.<\/div>\n
<\/div>\n
\u2003\u2022 IMPROVE-Bleed (for bleeding risk):<\/div>\n
\u2003\u2003\u2022 Prior major bleed (4 pts)<\/div>\n
\u2003\u2003\u2022 Platelets < 50 000 (4)<\/div>\n
\u2003\u2003\u2022 Severe renal failure (CrCl < 30 mL\/min) (2.5)<\/div>\n
\u2003\u2003\u2022 Liver failure (2.5)<\/div>\n
\u2003\u2003\u2022 Active cancer (2)<\/div>\n
\u2003\u2003\u2022 Age \u2265 85 (3.5)<\/div>\n
\u2003\u2003\u2022 Central line, ICU stay, or rheumatic disease (1\u20132)<\/div>\n
\u2003\u2192 \u2265 7 pts = high bleeding risk \u2192 avoid or shorten prophylaxis.<\/div>\n
<\/div>\n
\u2003If VTE \u2265 4 and Bleed < 7: use LMWH 40 mg SC daily or UFH 5000 U SC every 8\u201312 h until mobility is restored.<\/div>\n
<\/div>\n
\u2022 Re-initiate GDMT early once hemodynamically stable \u2014 SGLT2 inhibitors and MRAs can start during hospitalization due to mild BP effect.<\/span><\/div>\n
\u2022 Identify and treat triggers early (CHAMPIT mnemonic: Coronary syndrome, Hypertension, Arrhythmia, Mechanical cause, PE, Infection, Tamponade).<\/span><\/div>\n
<\/div>\n
5. Pre-Discharge & Transition of Care<\/div>\n
\u2022 Confirm complete decongestion, stable weight, and optimized oral diuretics.<\/span><\/div>\n
\u2022 Review renal function \/ electrolytes, ensure SBP > 100 mmHg, SaO\u2082 > 92 %.<\/span><\/div>\n
\u2022 Arrange early follow-up within 7\u201314 days, with clear GDMT titration plan and rehabilitation referral.<\/span><\/div>\n
<\/div>\n
6. <\/span>Discharge Readiness & Risk Tools<\/div>\n
\u2003\u2022 Safe discharge criteria: improved symptoms, SBP > 100, HR < 90, RR < 20, stable biomarkers, no ischemia\/arrhythmia, adequate social support, and early follow-up arranged.<\/div>\n
\u2003\u2022 HEARTRISK6 score: used after initial stabilization in the emergency department (ED) to decide if a patient with acute heart failure (AHF) can be safely discharged or should be admitted.<\/div>\n
\u2003\u2003Includes valvular disease, high HR, early NIV (Non-Invasive Ventilation), elevated creatinine (\u2191Cr), elevated troponin, and abnormal post-treatment vitals.<\/div>\n
\u2003\u2003\u2192 Score \u2265 3 = moderate\/high risk \u2192 admit; Score < 3 = low risk \u2192 consider discharge if stable.<\/div>\n
<\/div>\n
7. Advanced & Rescue Therapies<\/div>\n
\u2022 Cardiogenic shock unresponsive to pharmacotherapy:<\/span><\/div>\n
\u2022 Escalate to mechanical circulatory support (MCS) \u2014 IABP, Impella, or VA-ECMO.<\/span><\/div>\n
\u2022 Door-to-ECMO concept: each minute saved improves neurologic survival in ECPR.<\/span><\/div>\n
\u2022 National proposal: create a CPR-ECMO Center under JCS + MoH for standardized ECPR and simulation training.<\/span><\/div>\n","protected":false},"excerpt":{"rendered":"

National JCS Heart Failure Protocols – (2025) Acute Heart Failure \u2013 Emergency and Early In-Hospital Management “Developed by the Jordan Cardiac Society (JCS) Heart Failure National Task Force” (Adapted from ESC 2021\u20132024 \/ 2023 updates, AHA\u2013ACC\u2013HFSA 2022\u20132025, NICE 2025, AHA\u2013ACLS 2025) 1. Rapid Recognition and Initial Assessment * Initial assessment must be clinical and concurrent […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9183","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9183","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=9183"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9183\/revisions"}],"predecessor-version":[{"id":9184,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9183\/revisions\/9184"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=9183"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=9183"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=9183"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}