10 results
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
Cardiovascular MRI ... Elevated troponin • Cardiogenic ... shock, sudden cardiac ... death Management ... Myocarditis #Diagnosis #Management
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
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
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
Cardiac Stress Testing
Exercise:
 • Everyone who can exercise should!
 • They must be able to raise
Cardiac Stress Testing ... • They must be able ... ($$$), PET CT/MRI ... COREIMpodcast #Cardiac ... Testing #cardiology #management
Shock and Vasoactive Drugs 
1) Determine type and etiology of shock
 • Distributive: Sepsis, Anaphylaxis, Neurogenic
Neurogenic • Cardiogenic ... : Acute MI, Acute ... inopressors #diagnosis #management ... #comparison #table
Shock - Diagnosis and Management Summary
 • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible
Diagnosis and Management ... dilated IVC - Cardiac ... resuscitation • Cardiogenic ... Shock - MI ... Cardiac surgery?
Shock Classification
Shock Definition: State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen
myxedema, beriberi CARDIOGENIC ... infarction, following cardiac ... pneumothorax, cardiac ... Types #diagnosis #management ... warm #wet #dry #table
Peripartum Cardiomyopathy - Summary
1. Definition
 • Towards the end of pregnancy to 5 months postpartum
ancestry, LGE on MRI ... Minority of Pts: cardiogenic ... and timing with Cardio-OB ... Delivery • Stable ... follow-up with Cardio-OB
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
hemodynamics and cardiac ... is essentially Cardiogenic ... Cardiac cath if ... differential #algorithm #management ... cardiology #treatment #table