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The VSR is what is causing the cardiogenicshock! Mechanical complications occur acutely and significantly alter hemodynamics leading to comp ensatory mechanism which usually involve vasoconstriction and tachycardia, both hallmarks of cardiogenicshock. PIRP is strongly associated with myocardial rupture.
Heparin bolus (4000u), infusion Plan for rate control 25 mg IV diltiazem given HR = 143 25 mg IV repeat dose diltiazem given HR = 143 Diltiazem drip 10 mg/ hr for ~20 min HR remained 140 - 155 Then the patient developed Cardiogenicshock and echo had poor contractility Amiodarone load given. Patient intubated.
The notes now refer to the patient being in cardiogenicshock, on pressors. hours from presentation, where he was found to have an acute thrombotic LAD occlusion which was stented with resulting TIMI 3 flow, but still the patient was in severe cardiogenicshock. Time = 3 hours: the next troponin returns at 60 ng/L.
24 will focus on the following three current guideline updates: American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines 2023 Atrial Fibrillation Guideline - Pharmacology II: Strokes vs. Bleeds, What Do the Guidelines Tell Us About Practical Management in A-fib? The Guidelines Sessions at ACC.24
Highlights include: Vexing Valves (Session 501) Extreme Makeover, Diet Edition - Debating Controversies in Cardiovascular Health (Session 502) Game of Shones (Session 503) Top Intervention Trials of 2023 (Session 504) The Great ECG Challenge (Session 505) Under Pressure, Debating Hemodynamics With the Experts (Session 506) Critical Care Cardiology (..)
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