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The patient was transported to the CCU for further medical optimization where a pulmonary artery catheter was placed. Authors' commentary: Cardiogenicshock in the setting of severe aortic stenosis. Fundamentally, cardiogenicshock is an issue of decreased cardiac output. NEJM 362(9):779; March 4, 2009.
Case Continued 2 days later the patient became increasingly tachycardic, hypotensive, ashen, clammy (in cardiogenicshock) and had a new murmur. Rupture can be either free wall rupture (causing tamonade) or septal rupture, causing ventricular septal defect with left to right flow and resulting pulmonary edema and shock.
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