Cardiogenic shock other diagnostic studies: Difference between revisions
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=== Swan Ganz Catheter === | === Swan Ganz Catheter === | ||
The [[Swan-ganz catheter]] or [[pulmonary artery catheter]] may be helpful in distinguishing cardiogenic shock from [[septic shock]] and in optimizing the patient's left ventricular filling pressures (see section on [[Cardiogenic shock#Treatment|Treatment below)]]. The presence of significant V waves (greatly exceeding the pulmonary [[capillary wedge pressure]]) on the [[pulmonary artery]] tracing suggests either acute [[mitral regurgitation]] or a [[ventricular septal defect]]. | The [[Swan-ganz catheter]] or [[pulmonary artery catheter]] has been gradually replaced by echocardiography with color Doppler throughout the years, however, it is still common pratcice in some centers. It may be performed for different situations, such as: confirm the diagnosis of cardiogenic shock following clinical evaluation, ensure adequacy of filling pressures as well as helping in possible adjustments in therapy. It may also be helpful in distinguishing cardiogenic shock from [[septic shock]] and in optimizing the patient's left ventricular filling pressures (see section on [[Cardiogenic shock#Treatment|Treatment below)]]. The presence of significant V waves (greatly exceeding the pulmonary [[capillary wedge pressure]]) on the [[pulmonary artery]] tracing suggests either acute [[mitral regurgitation]] or a [[ventricular septal defect]]. | ||
*This technique is recommended for [[MI]] patients who are severely [[hypotensive]], however, several centers are gradually switching to a less [[invasive]] approach, managing cardiogenic shock patients by their clinic complemented by [[echocardiography]], instead of using the [[PA catheter]]. <ref name="ReynoldsHochman2008">{{cite journal|last1=Reynolds|first1=H. R.|last2=Hochman|first2=J. S.|title=Cardiogenic Shock: Current Concepts and Improving Outcomes|journal=Circulation|volume=117|issue=5|year=2008|pages=686–697|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.106.613596}}</ref><ref name="Antman2004">{{cite journal|last1=Antman|first1=E. M.|title=ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)|journal=Circulation|volume=110|issue=5|year=2004|pages=588–636|issn=0009-7322|doi=10.1161/01.CIR.0000134791.68010.FA}}</ref> | *This technique is recommended for [[MI]] patients who are severely [[hypotensive]], however, several centers are gradually switching to a less [[invasive]] approach, managing cardiogenic shock patients by their clinic complemented by [[echocardiography]], instead of using the [[PA catheter]]. <ref name="ReynoldsHochman2008">{{cite journal|last1=Reynolds|first1=H. R.|last2=Hochman|first2=J. S.|title=Cardiogenic Shock: Current Concepts and Improving Outcomes|journal=Circulation|volume=117|issue=5|year=2008|pages=686–697|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.106.613596}}</ref><ref name="Antman2004">{{cite journal|last1=Antman|first1=E. M.|title=ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)|journal=Circulation|volume=110|issue=5|year=2004|pages=588–636|issn=0009-7322|doi=10.1161/01.CIR.0000134791.68010.FA}}</ref> | ||
Revision as of 20:00, 27 May 2014
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Cardiogenic Shock Microchapters |
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Cardiogenic shock other diagnostic studies On the Web |
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American Roentgen Ray Society Images of Cardiogenic shock other diagnostic studies |
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Risk calculators and risk factors for Cardiogenic shock other diagnostic studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Other Diagnostic Studies
Swan Ganz Catheter
The Swan-ganz catheter or pulmonary artery catheter has been gradually replaced by echocardiography with color Doppler throughout the years, however, it is still common pratcice in some centers. It may be performed for different situations, such as: confirm the diagnosis of cardiogenic shock following clinical evaluation, ensure adequacy of filling pressures as well as helping in possible adjustments in therapy. It may also be helpful in distinguishing cardiogenic shock from septic shock and in optimizing the patient's left ventricular filling pressures (see section on Treatment below). The presence of significant V waves (greatly exceeding the pulmonary capillary wedge pressure) on the pulmonary artery tracing suggests either acute mitral regurgitation or a ventricular septal defect.
- This technique is recommended for MI patients who are severely hypotensive, however, several centers are gradually switching to a less invasive approach, managing cardiogenic shock patients by their clinic complemented by echocardiography, instead of using the PA catheter. [1][2]
Biopsy
In case of suspected cardiomyopathy a biopsy of heart muscle may be of benefit in establishing a definitive diagnosis.
References
- ↑ Reynolds, H. R.; Hochman, J. S. (2008). "Cardiogenic Shock: Current Concepts and Improving Outcomes". Circulation. 117 (5): 686–697. doi:10.1161/CIRCULATIONAHA.106.613596. ISSN 0009-7322.
- ↑ Antman, E. M. (2004). "ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)". Circulation. 110 (5): 588–636. doi:10.1161/01.CIR.0000134791.68010.FA. ISSN 0009-7322.