Post Myocardial Infarction Cardiogenic Shock

Ng, Ramford; Yeghiazarians, Yerem

doi:10.1177/0885066611411407

Cited by 24 publications

(19 citation statements)

References 116 publications

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“…The right ventricular regions more commonly affected by infarction are the inferior and inferior posterior aspects. The right coronary artery or left circumflex coronary artery in a left dominant system are the arteries frequently occluded in this setting 9,10 . In a right dominant system, patients with right coronary artery occlusion are at a higher risk of developing papillary muscle rupture and therefore undergoing valvular heart disease such as mitral regurgitation 11,12 .…”

Section: Pathophysiologymentioning

confidence: 99%

Pulmonary Hypertension in A Patient with Systemic Sclerosis

S.T¹,

Ezennaka²

2017

IOSR JDMS

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INTRODUCTION:Cardiogenic shock (CS) is defined as a state of critical end organ hypoperfusion due to reduced cardiac output.The most frequent cause is acute myocardial infarction (AMI) with subsequent ventricular dysfunction in about 80% of cases. In spite of the advances made in the treatment of AMI, cardiogenic shock remains a leading cause of death with mortality rates approaching 40-50%. AIM: The purpose of this review is to highlight the current concepts in the management of cardiogenic shock. MATERIALS AND METHODS: A systematic review of published literature using PubMed and Med Line was done using search items like "cardiogenic and shock". Secondary references obtained from this publication were identified by manual search and reviewed as relevant. RESULTS: Cardiogenic shock is characterized by inadequate tissue perfusion in the setting of adequate intravascular volume. The treatment involves general supportive measures which include; adequate oxygenation and ventilation, correction of electrolytes and acid-base abnormalities, pain reliefand restoration of sinus rhythm. Revascularizationand mechanical supports are also necessary. CONCLUSION:The diagnosis and management of cardiogenic shock are difficult and require extensive knowledge and clinical experience. In spite of the significant advances made, the management still remains a challenge.

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Section: Pathophysiologymentioning

confidence: 99%

Pulmonary Hypertension in A Patient with Systemic Sclerosis

S.T¹,

Ezennaka²

2017

IOSR JDMS

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“…Patients with shock may require vasopressors and inotropes to maintain tissue oxygen delivery, but these carry the risk of worsening the left-toright shunt. Intraaortic balloon pump counterpulsation is effective for decreasing left ventricular afterload and supporting cardiac output, but the benefits wane after 24 hours (8).…”

Section: Case Conferencesmentioning

confidence: 99%

A 68-Year-Old Man with Acute Respiratory Failure and Hypotension

Steinbach

Luks

2015

Annals ATS

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A 68-year-old man developed acute, severe dyspnea while convalescing at an adult family home after a hospital admission for pneumonia. On transfer by paramedics to the emergency department he was noted to have shock and severe hypoxemia. Bedside ultrasound revealed a severely dilated right ventricle, prompting a therapeutic intervention. Case VignetteA 68-year-old man with a past medical history of hypertension, hemorrhagic stroke, and tobacco use and a family history of coronary artery disease was convalescing at an adult family home after a recent hospital admission for community-acquired pneumonia when he was noted to develop acute dyspnea. On arrival at his residence, the paramedics found the patient moaning, with a Glasgow Coma Scale score of 8 and increased work of breathing.On arrival at the emergency department, his temperature was 36.2 8 C; heart rate, 47 beats/minute; blood pressure, 97/56 mm Hg; respiratory rate, 36 breaths/minute; and he had an oxygen saturation of 70% while he breathed oxygen via a nonrebreather mask. The patient was intubated on an emergency basis. Physical examination after intubation and initiation of sedation revealed a wellnourished, unresponsive man. The trachea was midline and lungs were clear to auscultation. Cardiac examination revealed regular bradycardia, no precordial heaves, and a grade III/VI holosystolic murmur along the left sternal border, which had not been noted during his previous hospitalization. There were diminished dorsalis pedis and radial pulses and his skin was cool to palpation. The abdomen was soft, nontender, and without organomegaly. There was no asymmetric lower extremity edema.

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“…It is known that a final infarct size after reperfusion therapy is a major key determinant of the prognosis of the patients with AMI . Thus, several strategies have been developed to reduce the infarct size and increase survival rate of these patients . Recently, the conditioning phenomenon (an ischemic preconditioning, ischemic postconditioning and remote ischemic conditioning) as well as the pharmacological interventions has been shown to reduce myocardial infarct size against I/R injury .…”

Section: Introductionmentioning

confidence: 99%