18 results
Inpatient Cath Lab Indications
Cath Lab ASAP:
STEMI
NSTEMI:
1. Unstable/cardiogenic shock
2. Severe LV dysfunction or
3. Recurrent/persistent rest angina despite
Cath Lab ASAP: STEMI ... NSTEMI: 1. ... Unstable/cardiogenic shock ... /UA: stable, TIMI ... #Inpatient #CathLab
Left Main Coronary Artery Thrombus seen on Angiography

“Mother of all coronary thrombi”.  55 year old
Anterior wall STEMI ... in Cardiogenic shock ... Patient was in shock ... established, but died on table ... LMCA #Angiogram #CathLab
Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
Shock - Differential ... a.k.a. neurogenic shock ... contractility) - Acute MI ... DrEricStrong #Shock ... Classification #Table
Bedside Classification of Shock

Hypovolemic shock 

- Vomiting, diarrhea, overdiuresis 

- Hemorrhage (GI, peritoneal, RP) 

Distributive shock
Classification of Shock ... Hypovolemic shock ... - Septic shock ... Endocarditis - Post-MI ... Cardiogenic #Comparison #Table
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM

INCLUSION CRITERIA
Acute Myocardial Infarction
 Ischemic Symptoms
 EKG and/or biomarker evidence of AMI
DETROIT CARDIOGENIC SHOCK ... INITIATIVE ALGORITHM ... evidence of AMI (STEMI ... Shock  Hypotension ... #Algorithm #DCSI
Shock and Vasoactive Drugs 
1) Determine type and etiology of shock
 • Distributive: Sepsis, Anaphylaxis, Neurogenic
Shock and Vasoactive ... and etiology of shock ... Cardiogenic: Acute MI ... #Vasopressors #shock ... management #comparison #table
Differentiating type-I vs. type-II MI

Sorting this out is difficult, often relying heavily on clinical judgement.

A key
type-I vs. type-II MI ... probably a type-2 MI ... The table below ... Type2 #Definition #NSTEMI ... #Comparison #Table
Flowchart guide to diagnosing sepsis and septic shock. Visit gramproject.com for more medical diagrams, tables and
sepsis and septic shock ... medical diagrams, tables ... #algorithm #diagnosis ... #sepsis #shock
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
Shock - Differential ... failure, acute MI ... uw_IMresidency #Shock ... Differential #Diagnosis #table
In July 2015 the ACC/AHA proposed and published an algorithm to help stratify cardiac arrest patients
and published an algorithm ... CardiacArrest #Algorithm ... ROSC #Comatose #CathLab ... #NSTEMI #Activation