17 results
Pulmonary Arterial Catheterization – Use and Interpretation:
-Pulmonary arterial catheterization (PAC) has never been shown to improve
Pulmonary Arterial Catheterization ... However, when the diagnosis ... or the type of shock ... severe cardiogenic shock ... #Differential #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 ... New/worsening MR ... Rx: NSTEMI/UA: stable ... #Indications #Cardiac ... #catheterization
Bedside Classification of Shock

Hypovolemic shock 

- Vomiting, diarrhea, overdiuresis 

- Hemorrhage (GI, peritoneal, RP) 

Distributive shock
Hypovolemic shock ... Anaphylaxis - Post-cardiac ... Endocarditis - Post-MI ... Cardiogenic #Comparison #Table ... #Diagnosis #Features
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
Myocarditis Diagnosis ... Cardiovascular MRI ... • Cardiogenic shock ... , sudden cardiac ... death Management
ISCHEMIA Trial - Management Algorithm for patients with Stable Angina

Stress Test -> ? +moderate or severe
ISCHEMIA Trial - Management ... LMCA lesion -> Cardiac ... Catheterization ... Angina #ChestPain #Diagnosis ... #Management #Algorithm
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
Shock - Differential ... Diagnosis Framework ... failure, acute MI ... uw_IMresidency #Shock ... #table #comparison
Shock and Vasoactive Drugs 
1) Determine type and etiology of shock
 • Distributive: Sepsis, Anaphylaxis, Neurogenic
Shock and Vasoactive ... Cardiogenic: Acute MI ... #inopressors #diagnosis ... #management #comparison ... #table
Shock - Diagnosis and Management Summary
 • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible
Shock - Diagnosis ... and Management ... - MI, arrhythmia ... Cardiac surgery? ... #Diagnosis #Management
Right Heart Catheterization - Pulmonary Artery Pressures and Calculations
PULMONARY VASCULAR RESISTANCE = (meanPAP-PCWP) / CO
 •
Right Heart Catheterization ... mortality in inferior MI ... CARDIAC POWER OUTPUT ... much as 40% in cardiac ... artery #catheter #diagnosis
Shock Classification
Shock Definition: State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen
infarction, following cardiac ... pneumothorax, cardiac ... Classification #Types #diagnosis ... #management #cold ... warm #wet #dry #table