Monday, February 3, 2020

Cardiogenic Shock

emDocs - February 3, 2020 - Authors: Daly M and Lentz s
Reviewed by: Montrief T; Koyfman A and Long B
"Take home points:
  • CS is primarily caused by an acute MI (~70%) and is the focus of most studies but other causes should also be considered (see full list in Figure 1).
  • Mortality secondary to CS remains high (~60%), although early identification and intervention improves survival.
  • Perform a careful physical exam looking for hypoperfusion and congestion. JVP is an important physical exam component for the diagnosis of CS and is associated with increased mortality (RR = 1.52).
  • The RUSH exam is both sensitive and specific (0.89 and 0.97, respectively) in the diagnosis of CS. Bedside ultrasound should be repeated frequently as most patients do not initially present in CS.
  • Using LVOT VTI is a simple and noninvasive method for evaluating CO with low measurements associated with adverse outcomes.
  • A suggested approach for evaluating patients with suspected CS with focus on its heterogeneous pathology and presentation is summarized in Figure 5."