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diagnosis criticalcare cardiology shock comparison differential classification treatment algorithm pharmacology cardiomyopathy causes clinical foamed indications overview summary vasopressors workup catheterization
Syncope Diagnostic Testing and Evaluation: Cost Effectiveness Frequency obtained - Abnormal findings - Helped determine etiology of
Syncope Diagnostic Testing ... ECG, Telemetry, Cardiac ... /S, EEG, Brain MRI ... , Cardiac stress ... Effectiveness #table
Hypertrophic Cardiomyopathy (HOCM) - Diagnosis and Management Diagnosis 1. Wall thickness 215 mm (TTE/CT/MRI) 2. Absence
Diagnosis and Management ... 215 mm (TTE/CT/MRI ... Supportive: genetic testing ... , LGE on MRI) Four ... Prevent Sudden 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 ... #Stress #Testing ... #cardiology #management
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
Approach to Undifferentiated Shock - OnePager Summary Shock occurs when there is inadequate blood flow (CO) &
4 categories: cardiogenic ... Problem (↓ CO): • CARDIOGENIC ... Pneumothorax, Cardiac ... pancreatitis, post-cardiac ... Renal Losses(salt-wasting
Vasopressors and Inotropes • Norepinephrine - Levophed - "Levo" - Generally thought of as the first
(arrhythmia in setting ... Dobutamine - Dobutrex - Cardiogenic ... Milrinone - Primacor - Cardiogenic ... Vasopressors #Inotropes #management ... summary #comparison #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
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
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