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Cardiology diseases > Hemodynamics causes CC > Flashcards

Hemodynamics causes CC Flashcards

1
Q

Static measures of fluid responsiveness

A
  • CVP
  • Pulmonary capillary wedge pressure
  • Clinical static endpoints (heart rate, blood pressure, etc).
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2
Q

Dynamic measures of fluid responsiveness

A
  • Pulse pressure variation
  • Stroke volume variation
  • IVC collapsibility
  • Response to passive leg raise
  • Fluid challenge
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3
Q

Causes of false positive IVC collapse

A
  • Elevated intra abdominal pressure
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4
Q

Causes of false positive IVC distention

A
  • Pneumothorax
  • Pericardial effusion
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5
Q

Elevations in RA pressure

A
  • Diseases of the right ventricle (eg, right ventricular infarction or cardiomyopathy)
  • Pulmonary hypertension
  • Pulmonic stenosis
  • Left-to-right shunts
  • Tricuspid valvular disease
  • Cardiac tamponade
  • Constrictive pericardial disease
  • Restrictive cardiomyopathies
  • Left ventricle systolic heart failure
  • Hypervolemia
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6
Q

Conditions in which PAW>LVEDP

A
  • Mitral stenosis
  • Left atrial myxoma
  • Pulmonary embolus
  • Mitral valve regurgitation
  • Pulmonary venocclusive disease
  • Pulmonary vein stenosis
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7
Q

Conditions in which PAW

A
  • Decreased LV compliance
  • High (>25 mmHg) LVEDP
  • Aortic valve regurgitation
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8
Q

Conditions in which PAW does not approximate PCWP (More than 1-4 mmHg difference)

A
  • Increased pulmonary vascular resistance
  • Pulmonary hypertension
  • Cor pulmonale
  • Pulmonary embolus
  • Eisenmenger’s syndrome
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9
Q

Conditions that cause elevated left ventricular end diastolic pressure LVEDP

A
  • Left ventricular systolic heart failure
  • Left ventricular diastolic heart failure
  • Mitral and aortic valve disease
  • Hypertrophic cardiomyopathy
  • Hypervolemia
  • Large right-to-left shunts
  • Cardiac tamponade, constrictive and restrictive cardiomyopathies
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10
Q

Conditions that cause a low wedge pressure

A
  • Hypovolemia (eg, hemorrhagic shock, severe intravascular volume depletion)
  • Pulmonary venoocclusive disease (variably normal or low)
  • Obstructive shock due to large pulmonary embolism
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11
Q

Causes that would consistently overestimate cardiac output in hemodilution method

A
  • Injectate that is warmer than programmed into the computer
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12
Q

Causes that would consistently underestimate cardiac output in hemodilution method

A
  • A larger than programmed injectate
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13
Q

Obstructive shock

A

Decreased venous return:

  • Cardiac tamponade
  • Abdominal compartment syndrome
  • Tension pneumothorax
  • Increased resistance to venous return
    • Tumor compression
    • Venous thrombosis
    • Increased PEEP/PEEP
    • Pregnancy

Increased ventricular afterload:

  • Increased PVR- Pulmonary embolism
  • Hypertensive crisis
  • Aortic dissection
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14
Q

Wide pulse pressure

A
  • Thyrotoxicosis
  • Arteriovenous fistula
  • Aortic insufficiency
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15
Q

Narrow pulse pressure

A
  • Significant tachycardia
  • Early hypovolemic shock
  • Pericarditis
  • Pericardial effusion or tamponade
  • Ascites
  • Aortic stenosis
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16
Q

Systolic hypertension

A
  • Increased cardiac output
  • Thyrotoxicosis
  • Generalized response to stress
  • Anemia
  • Pain, anxiety, or both
17
Q

Diastolic hypertension

A
  • Intrinsic renal disease
  • Endocrine disorders
  • Renovascular hypertension
  • Neurologic disorders
18
Q

Management options which decrease preload

A
  • Diuretics (e.g., furosemide): decrease systemic venous tone and extracellular volume/volume overload
  • Opiates (e.g., morphine sulfate) reduce sympathetic tone
  • Nitrates (e.g., nitroglycerin): venous and arterial vasodilator, reduce myocardial oxygen demand
  • Nesiritide: recombinant BNP that results in vasodilation and diuresis
  • Ultrafiltration (volume removal)
19
Q

Management options which decrease afterload

A
  • ACE inhibitor/ARB: reduce preload and afterload
  • Nitroprusside (decreases venous return and afterload)
  • Nitrate
  • Hydralazine
  • Intraaortic balloon pump
20
Q

Vasoactive drugs working on β1 receptors

A
  • Dobutamine
  • Epinephrine (LD)
  • Norepinephrine
21
Q

Vasoactive drugs working on α1 receptors

A
  • Phenylephrine
  • Norepinephrine
  • Epinephrine
22
Q

Vasoactive drugs working on β2/PDEi receptors

A
  • Dobutamine
  • Dopamine (Low Dose)
  • Milrinone
  • Isoproterenol
23
Q

List of pulse contour analysis devices

24
Q

Causes of overdamped arterial line

A
  • Clot
  • Air
  • kinks
  • Loose connections
  • Arterial spasm
  • Narrow tubing

Link

25
Q

Correctable metabolic causes of depressed contractility

A
  • Hypoxia
  • Acidosis (pH<7.3)
  • Hypophosphatemia
  • Adrenal insufficiency
  • Hypothermia
26
Q

Causes of underdamped arterial line

A
  • Catheter whip or artefact
  • Stiff non-compliant tubing
  • Hypothermia
  • Tachycardia or dysrhythmia

Cardiology diseases (15 decks)

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