Cardiogenic shock Flashcards
Classic most common picture of acute cardiogenic shock is due to __ infarction
LV
About 10% of cardiogenic shock after AMI is caused by _____ complications
mechanical
Soft holosystolic murmur at the apex radiating to the axilla signifies acute ____ caused by chordae tendinae rupture/ papillary muscle dysfx
mitral regurgitation
Acute ___ is associated w new loud holosystolic L parasternal murmur, often w a palpable thrill that dec in intensity as intraventricular pressures equalize
VSD
Suspect acute ___ when you find a soft diastolic murmur and a softer S1 sound
aortic insufficiency
Treatment of hypotension in patients w no evidence of pulmo congestion
Attempt fluid boluses of 250 - 500 mL and reassess
Treatment of hypotension in patients w evidence of pulmo congestion
If SBP <90, combine dobutamine with dopamine or NE
If SBP <70, administer NE
Indicator of LV dysfx but does not identify the cause
Serum B -type natriuretic peptide
POCUS finding of aortic root >3 cm, suspect __ when assoc w pericardial effusion
Ascending aortic dissection
POCUS view that visualizes pericardial effusion and cardiac tamponade
subcostal 4-chamber view
Subcostal, parasternal and apical views in POCUS can help estimate __ & __
Ejection fraction & cardiac contractility
Do NOT use __-blockers in px w MI in cardiogenic shock or who are at risk for cardiogenic shock
alpha-blockers
Mainstay of initial pharmacologic treatment in the absence of profound hypotension
Dobutamine
Avoid use of dobutamine alone when the SBP <90 because of its ___ potential
vasodilatory potential
Vasopressor w some inotropic effect but may inc HR & LVEDP by B agonist effect
Dopamine
