21 results
Pulmonary Arterial Catheterization – Use and Interpretation:
-Pulmonary arterial catheterization (PAC) has never been shown to improve
Pulmonary Arterial Catheterization ... Pulmonary arterial catheterization ... or the type of shock ... severe cardiogenic shock ... #Differential #Table
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
Cardiovascular MRI ... • Dysrhythmia, heart ... block • Heart ... • Cardiogenic shock ... , sudden cardiac
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
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 ... #Catheterization
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 ... Endomyocardial: Carcinoid Heart
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
Shock - Differential ... failure): • Severe heart ... failure, acute MI ... uw_IMresidency #Shock ... Differential #Diagnosis #table
Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
Shock - Differential ... a.k.a. neurogenic shock ... contractility) - Acute MI ... - Severe heart ... Classification #Table
Bedside Classification of Shock

Hypovolemic shock 

- Vomiting, diarrhea, overdiuresis 

- Hemorrhage (GI, peritoneal, RP) 

Distributive shock
Classification of Shock ... Hypovolemic shock ... Anaphylaxis - Post-cardiac ... Endocarditis - Post-MI ... Cardiogenic #Comparison #Table
Shock and Vasoactive Drugs 
1) Determine type and etiology of shock
 • Distributive: Sepsis, Anaphylaxis, Neurogenic
Shock and Vasoactive ... and etiology of shock ... Cardiogenic: Acute MI ... , Acute Heart Failure ... management #comparison #table
Approach to Undifferentiated Shock - OnePager Summary
Shock occurs when there is inadequate blood flow (CO) &
), LV Failure (MI ... Valves (wide open MR ... Pneumothorax, Cardiac ... pancreatitis, post-cardiac ... Losses (bums, heat