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Circulation, Volume 151, Issue 3 , Page 257-271, January 21, 2025. Advances in critical care therapies for patients with cardiogenicshock (CS), including temporary mechanical circulatory support and multidisciplinary shock teams, have led to improved survival to hospital discharge, ranging from 60% to 70%.
Publication date: Available online 24 January 2025 Source: The American Journal of Cardiology Author(s): Eric J. Hall, Colby R. Ayers, Nicholas S. Hendren, Christopher Clark, Amit Saha, Hadi Beaini, Isabella L. Alexander, Evan P. Gee, Ian R. McConnell, Emily S. Samson, Roslyn J. Saplicki, Christopher S. Grubb, Grant Tucker, Justin L.
Publication date: Available online 18 March 2025 Source: The American Journal of Cardiology Author(s): Masashi Azuma, Suyog Mokashi, Mohammed Abul Kashem, Brian O'Murchu, Yoshiya Toyoda, Roh Yanagida
Shes in impella dependent cardiogenicshock w new renal failure. "And they hit the carotid trying to place an Impella, caused a big hematoma where she had precipitous airway occlusion. Just awful all around. Ill check for updates and other ekgs when I log in later today." Post cath ekg here.
Welcome to 2025 and best wishes for a great academic journey to all readers. 24) Microaxial Flow Pump in Infarct-Related CardiogenicShock DanGer Shock (ACC.24) 24) Microaxial Flow Pump in Infarct-Related CardiogenicShock DanGer Shock (ACC.24) Thanks to ACC for compiling it.
Assessment : Cardiology thought this was cardiogenicshock from RV dysfunction. Smith Comment: the RV was very ischemic on the CT scan and dysfunctional on echo, and this does explain the shock. Probable anterior and anterolateral wall hypokinesis. Right ventricular enlargement. Decreased right ventricular systolic performance.
A 2017 trial named CULPRIT SHOCK found that in patients with cardiogenicshock, a strategy of culprit vessel PCI only was associated with better outcomes than immediate multivessel PCI. After CULPRIT SHOCK, many shied away from multivessel PCI in the acute setting. In fact, in this elegant study by Heitner et al.
Whenever there is tachycardia, I am skeptical of OMI unless it has led to severely compromised ejection fracction with cardiogenicshock. However, there is also significant tachycardia , with heart rate of 116, and known hypoxia. Or I suspect that there is OMI simultaneous with another pathology.
1) as far as I can tell, there is very little data on amiodarone for this indication 2) amiodarone has beta blockade effects which could be deleterious in a patient with large anterior MI with pulmonary edema and at risk for cardiogenicshock (and she did go into shock. I focus my comment on expanding as to why this is so.
See our other cases with similar patters, to burn this deep into your brain files: Smith : In my experience, these cases of LAD OMI with RBBB and LAFB are either about to arrest, post-arrest, and/or in cardiogenicshock. The ST Elevation is NOT typical. It is ofen downsloping This one is also a wide complex tachycardia.
Anyone who has seen and studied OMI patients knows that this patient with proximal LAD pattern, with super high risk ischemic RBBB, and tachycardia, is in cardiogenicshock until proven otherwise. This pattern has very high mortality. The Emergency Physician contacted the Cardiologist immediately asking for cath lab activation.
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