17 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
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
Classification of Shock ... Hypovolemic shock ... Anaphylaxis - Post-cardiac ... Endocarditis - Post-MI ... Cardiogenic #Comparison #Table
ISCHEMIA Trial - Management Algorithm for patients with Stable Angina

Stress Test -> ? +moderate or severe
ISCHEMIA Trial - Management ... LMCA lesion -> Cardiac ... Catheterization ... evaluation or management ... ChestPain #Diagnosis #Management
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
Cardiovascular MRI ... • Cardiogenic shock ... , sudden cardiac ... death Management ... Myocarditis #Diagnosis #Management
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 ... inopressors #diagnosis #management ... #comparison #table
Shock - Diagnosis and Management Summary
 • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible
and Management ... dilated IVC - Cardiac ... - MI, arrhythmia ... Cardiac surgery? ... #Diagnosis #Management
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
Shock - Differential ... failure, acute MI ... → tension PTX, cardiac ... uw_IMresidency #Shock ... Differential #Diagnosis #table
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 ... #Right #Heart #Catheterization
Shock Classification
Shock Definition: State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen
shock. ... infarction, following cardiac ... pneumothorax, cardiac ... Types #diagnosis #management ... warm #wet #dry #table