Cardiogenic shock chest x ray
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2] Syed Musadiq Ali M.B.B.S.[3]
Overview
Chest radiographic findings are useful for excluding other causes of shock or chest pain. The presence of a widened mediastinum may indicate aortic dissection. Tension pneumothorax or pneumomediastinum that are readily detected on radiographic films may manifest as low-output shock. Most patients with established cardiogenic shock exhibit findings of LV failure, the radiologic features of which include pulmonary vascular redistribution, interstitial pulmonary edema, enlarged hilar shadows, the presence of Kerley B lines, cardiomegaly, and bilateral pleural effusions. Alveolar edema manifests as bilateral perihilar opacities in a so-called butterfly distribution.
Chest X-ray
Although not an ideal method to diagnose cardiogenic shock, the chest x-ray may provide important information such as:[1][2]
- Rulling out conditions like pneumonia, which may be the cause of other types of shock
- Identification of cardiomegaly in the patient with tamponade
- Identification of a widened mediastinum, which may be present in the patient with aortic dissection
- Exclusion of a tension pneumothorax possibly associated with hypotension
- Confirmation of pulmonary edema, consequence of cardiogenic shock
- Diagnosis of tension pneumothorax
- However, it is not a reliable predictor of pulmonary capillary wedge pressure
References
- ↑ Parrillo, Joseph (2013). Critical care medicine principles of diagnosis and management in the adult. Philadelphia, PA: Elsevier/Saunders. ISBN 0323089291.
- ↑ 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.