18 results
PCI in Acute MI with Cardiogenic Shock. #EBM #Cardiology #CULPRITSHOCK #PCI #VisualAbstract #NEJM
PCI in Acute MI ... with Cardiogenic ... Shock. ... VisualAbstract #NEJM
Common Vasopressors and Inotropes
Norepinephrine (NE)
 - Indication: Distributive shock (1st line for septic shock), Cardiogenic shock
), Cardiogenic shock ... Tachyarrhythmias, Cardiac ... Tachyarrhythmias, Cardiac ... Tachyarrhythmias, Cardiac ... Inotropes #comparison #table
Bedside Classification of Shock

Hypovolemic shock 

- Vomiting, diarrhea, overdiuresis 

- Hemorrhage (GI, peritoneal, RP) 

Distributive shock
Hypovolemic shock ... Anaphylaxis - Post-cardiac ... Endocarditis - Post-MI ... #Distributive #Cardiogenic ... #Comparison #Table
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
Cardiovascular MRI ... Elevated troponin • Cardiogenic ... shock, sudden cardiac
Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
Shock - Differential ... a.k.a. neurogenic shock ... ) Cardiogenic ( ... contractility) - Acute MI ... Classification #Table
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
Shock - Differential ... pressure, pallor Cardiogenic ... failure, acute MI ... uw_IMresidency #Shock ... Differential #Diagnosis #table
Approach to Undifferentiated Shock - OnePager Summary
Shock occurs when there is inadequate blood flow (CO) &
4 categories: cardiogenic ... Problem (↓ CO): • CARDIOGENIC ... ), LV Failure (MI ... Pneumothorax, Cardiac ... pancreatitis, post-cardiac
Shock and Vasoactive Drugs 
1) Determine type and etiology of shock
 • Distributive: Sepsis, Anaphylaxis, Neurogenic
Shock and Vasoactive ... and etiology of shock ... Neurogenic • Cardiogenic ... : Acute MI, Acute ... management #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 ... shock 2. ... New/worsening MR ... Rx: NSTEMI/UA: stable ... #Indications #Cardiac
Shock - Diagnosis and Management Summary
 • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible
Shock - Diagnosis ... dilated IVC - Cardiac ... resuscitation • Cardiogenic ... Shock - MI ... Cardiac surgery?