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PCI in Acute MI with Cardiogenic Shock. #EBM #Cardiology #CULPRITSHOCK #PCI #VisualAbstract #NEJM
PCI in Acute MI ... with Cardiogenic ... #EBM #Cardiology ... VisualAbstract #NEJM
Myocarditis - Diagnosis and Causes
 • Clinical presentation: Pseudo-acute coronary syndrome, Cardiac failure <3 rnonths, Cardiogenic
coronary syndrome, Cardiac ... failure <3 rnonths, Cardiogenic ... Troponin Increases, Cardiac ... Diagnosis #Causes #cardiology ... #MRI
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
Cardiovascular MRI ... Elevated troponin • Cardiogenic ... shock, sudden cardiac ... Diagnosis #Management #Cardiology
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM

INCLUSION CRITERIA
Acute Myocardial Infarction
 Ischemic Symptoms
 EKG and/or biomarker evidence of AMI
SHOCK INITIATIVE ALGORITHM ... Fick calculated cardiac ... IF LVEDP >15 or Cardiac ... #Shock #Algorithm ... Initiative #Management #Cardiology
Inpatient Cath Lab Indications
Cath Lab ASAP:
STEMI
NSTEMI:
1. Unstable/cardiogenic shock
2. Severe LV dysfunction or
3. Recurrent/persistent rest angina despite
Unstable/cardiogenic ... New/worsening MR ... Rx: NSTEMI/UA: stable ... #Indications #Cardiac ... catheterization #cardiology
Bedside Classification of Shock

Hypovolemic shock 

- Vomiting, diarrhea, overdiuresis 

- Hemorrhage (GI, peritoneal, RP) 

Distributive shock
Anaphylaxis - Post-cardiac ... Endocarditis - Post-MI ... #Distributive #Cardiogenic ... #Comparison #Table
Cardiogenic Shock - Diagnostic Algorithm
Suspicion of cardiogenic shock: Hypoperfusion with suspected cardiac etiology

#Cardiogenic #Shock #Diagnosis #Algorithm
Cardiogenic Shock ... - Diagnostic Algorithm ... with suspected cardiac ... Shock #Diagnosis #Algorithm ... #workup #cardiology
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
pressure, pallor Cardiogenic ... (Intra-cardiac ... failure, acute MI ... → tension PTX, cardiac ... Differential #Diagnosis #table
Restrictive Cardiomyopathy - Diagnosis and Causes
Clinical: Dyspnea, Exercise Intolerance, ↑ "Right Sided-Symptoms" (ascites, hepatomegaly, ↑↑peripheral edema)
Physical
Descents, Rales,+S4, MR ... Echocardiography, Cardiac ... MRI, Cardiac Catheterization ... #differential #cardiology ... #algorithm
Cardiac Murmurs and Maneuvers

An algorithm demonstrating the effect of various maneuvers on systolic murmurs. 
TR, tricuspid
Cardiac Murmurs ... Maneuvers An algorithm ... stenosis; MVP/MR ... DrJayMohan #Cardiac ... Maneuvers #Heart #Cardiology