Cardiogenic shock cs is characterized by systemic hypoperfusion due to severe depression of the cardiac index 18 mmhg. View and download powerpoint presentations on hypovolemic shock ppt. The fundamental problem in cardiogenic shock is the inability of the heart to pump adequate amounts of blood to vital organs. Tilarginine acetate injection in a randomized international study in unstable acute myocardial infarction patients with cardiogenic shock triumph powerpoint ppt. Youll receive medications and fluid through an intravenous iv line in your arm. The thickness of the arrows schematically represents the strength of the linkage depending on the severity and duration of the disorder and on the patients physiologic reserve. Remove this presentation flag as inappropriate i dont like this i like this remember as a favorite.
Ppt cardiogenic shock powerpoint presentation free to. Parrillo, md professor of medicine, robert wood johnson medical school university of medicine and dentistry of new jersey head, division of cardiovascular disease and critical care medicine director, cooper heart institute. Definition cardiogenic shock is a state of endorgan hypoperfusion due to cardiac failure pulmonary artery pa catheterization. Learn about its causes, treatment, outcome and more from cleveland clinic. Cardiogenic shock backgroundpatient presentation cyanotic and. Cardiogenic shock develops as a result of the failure of the heart in its function as a pump, resulting in inadequate cardiac output. Cardiogenic v v septic v or v prevalence occurs in 58% of stemi and 2.
This complication occurred in the early postoperative period and reversed immediately after treatment with intravenous verapamil. Mar 21, 2017 download the detroit cardiogenic shock initiative treatment algorithm. This leads to acute hypoperfusion and hypoxia of the tissues and organs, despite the presence of an adequate intravascular volume. Jul 23, 2015 cardiogenic shock occurs when there is failure of the pump action of the heart, resulting in a decrease in cardiac output causing reduced endorgan perfusion. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects. Revascularization strategies in cardiogenic shock patients. Cardiogenic shock is the syndrome that ensues when the heart is unable to deliver enough blood to maintain adequate tissue perfusion. The extent of myocardial salvage from reperfusion treatment decreases exponentially with time to reestablishing coronary flow. Despite advances in reperfusion and mechanical circulatory support, management remains highly variable and outcomes poor. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience. Standardized teambased care for cardiogenic shock jacc.
Cardiogenic shock cs is a complex and highly morbid entity conceptualised as a vicious cycle of injury, cardiac and systemic decompensation, and further injury and decompensation. Cardiogenic shock cs and pulmonary edema are lifethreatening high acuity conditions that require treatment as medical emergencies, usually in an intensive care unit icu or cardiac intensive care unit cicu. Cardiogenic shok some notes develops in 10% to 20% of patients hospitalized ami mortality of such patients approximately 80% or higher very few patients develop shock immediately after ami about half of the patients develop shock within 24h pathology clinical signs ecg shows the pattern of ami or acute coronary insufficiency the sbp treatment, nearly 50% of patients with cardiogenic shock still do not survive to hospital discharge. The most common cause of cardiogenic shock is damage to the heart muscle from a severe heart attack. View and download powerpoint presentations on cardiogenic shock pharmacological management ppt. This can done in a number of waysfluid resuscitation, blood transfusions, vasopressors, and ionotropes. Cs is caused by severe impairment of myocardial performance that results in diminished cardiac output, end. If cardiogenic shock is due to a heart attack, attempts to open the hearts arteries may help. Youll receive medications and fluid through an intravenous iv line in. Cardiogenic shock cs is a common cause of mortality, and management remains. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. During this treatment, which most people who have cardiogenic shock need, youre given extra oxygen to breathe, to minimize damage to your muscles and organs. This chapter will outline the underlying causes and diagnostic criteria, pathophysiology, and treatment of cardiogenic shock complicating acute coronary syndromes, including mechanical complications and shock.
Cardiogenic shock cs is a high acuity, complex, and hemodynamically diverse state of endorgan hypoperfusion that is associated with multisystem organ failure. Careful risk assessment for each patient, based on clinical criteria, is. A free powerpoint ppt presentation displayed as a flash slide show on id. Sepsisinfectious issues prevention and management 5. This damage prevents the hearts main pumping chamber, the left ventricle from working well. Oneills presentation on abiomeds impella quality assurance program and the importance of treatment protocols to improve patient survival and heart recovery. Treatment recommendations are specific to patient groups. Management of cardiogenic shock complicating acute. Fredric ginsberg, md assistant professor of medicine, robert wood johnson medical school university of medicine and dentistry of new jersey joseph e.
For the 4th lesson in our series on shock we take a good look at cardiogenic shock. Cardiogenic shock advanced hf cardiogenic shock the role of the cardiac intensivist 1. It is associated with inhospital mortality rates 50%. Treatment of cardiogenic shock depends on the cause with the initial goals to improve blood flow to the body. Detroit csi treatment algorithm exclusion criteria septic, anaphylactic, hemorrhagic, and neurologic cuases of shock non ischemic causes of shockhypotension pulmonary embolism, pneumothorax, myocarditis, etc active bleeding recent major surgery mechanical complications of ami known left ventricular thrombus. Additionally, the mortality is greater than 50% goldberg 1999. These patients should be treated with aggressive medical therapy and be evaluated. The extent of ischaemic myocardium has a profound impact on the initial, inhospital, and postdischarge management and prognosis of the cardiogenic shock patient. Cardiogenic shock cs remains the most common cause of death in patients admitted with acute myocardial infarction ami and mortality remained nearly unchanged in the range of 4050% during the last two decades. Hemodynamic findings in cardiogenic shock include a reduced cardiac output without evidence of hypovolemia. Cardiogenic shock is the leading cause of inhospital death in patients with acute myocardial infarction ami. Cardiogenic shock occurs when a suddenly weakened heart usually weakened from a heart attack cant supply the body with the needed amount of blood and oxygen.
While acute myocardial infarction ami is the major cause of cardiogenic shock, other diagnostic considerations should always be entertained. The adobe flash plugin is needed to view this content. Cardiogenic shock complicating ami occurs in the range from 5 to 15%. Cardiogenic shock cs remains the leading cause of death in acute myocardial infarction ami, despite improvements in the treatment of ami and cs in the past decade. It is most likely that the next gamechanger in the treatment of cardiogenic shock is going to be timely initiation of powerful mechanical circulatory support. Types cardiogenic shock associated with cardiac pathology hypovolemic shock caused by inadequate blood volume anaphylactic shock caused by allergic reaction septic shock associated with infections neurogenic shock caused by damage to the nervous system metabolic associated with metabolic acidosis, hypothyroidism, addisonian crisis. Cardiogenic shock in patients with acute coronary syndromes. Sites participating in the national cardiogenic shock initiative csi have adopted the national csi algorithm as the foundatio. One challenge of guidelines is that the way recommendations are stated can potentially lead to oversimplification of complex situations. The randomized impella versus iabp reduces mortality in stemi patients treated with primary pci in severe cardiogenic shock impress in severe shock should we emergently. Cardiogenic shock united states pdf ppt case reports. Ppt cardiogenic shock powerpoint presentation free to download id.
Almost no one survived cardiogenic shock in the past. Looking to realworld evidence in cardiogenic shock dr. Em in 5 blog is a series of 5 minute emergency medicine lectures on high yield topics. Today, half of the people who experience cardiogenic shock survive with prompt treatment. Management of cardiogenic shock dr noor e khuda topu,md thesis part. Download the stages of cardiogenic shock fact sheet download the scai shock pyramid teaching slides. Scribd is the worlds largest social reading and publishing site. Causes of cardiogenic shock immediate causes cardiogenic shock occurs if the heart suddenly cant pump enough oxygenrich blood to the body. Pathophysiology and representative case presentation. Share the scai shock classification system with your colleagues using these teaching slides designed for easy dissemination. Recent research has suggested that the peripheral vasculature and neurohormonal and cytokine systems play a role in the pathogenesis and persistence of cs. Cardiogenic shock is an acute state of decreased cardiac output resulting in inadequate tissue perfusion despite adequate circulating volume. Noorekhuda md final part student cardiology,dmch 2.
Winner of the standing ovation award for best powerpoint templates from presentations magazine. Find powerpoint presentations and slides using the power of, find free presentations research about hypovolemic shock ppt. Management of cardiogenic shock complicating acute coronary. Cardiogenic shock cs is a clinical condition of inadequate tissueend organ perfusion due to cardiac dysfunction hypotension sbp may 26, 2016 cardiogenic shock 1. Doppler echocardiography used to confirm elevation of lv filling pressures circulation.
Its management is detailed, including specific forms of therapy for the various subgroups of patients in whom cardiogenic shock is an integral part. View and download powerpoint presentations on shock types of shock ppt. Pediatric cardiogenic shock is an often insidious phenomenon with presentations requiring a broad differential diagnosis. Cardiogenic shock treatment focuses on minimizing the damage from lack of oxygen to your heart muscle and other organs. Norepinephrine as a firstline inopressor in cardiogenic shock. Management of cardiogenic shock complicating myocardial. Department of cardiology current management issues of cardiogenic shock gopal c ghosh unit1. Objectives introduction cardiogenic shock definition symptoms causes clinical manifestation diagnosis treatment. A 62 yrs old male is brought to the ed with sudden onset chest pain, exessive sweating, nausea and dyspnoea no other medical history is known.
Cs occurs in 58% of amis, with 2% of cs more than onequarter of the total being present at the time of admission. Objectives this study investigated whether a standardized teambased approach can improve outcomes in cs and whether a risk score can guide clinical. Parrillo, md professor of medicine, robert wood johnson medical school university of medicine and dentistry of new jersey head, division of cardiovascular disease and critical care medicine director, cooper. Cardiogenic shock is an extremely morbid condition. Acute myocardial infarction mi is the leading cause, but other potential etiologic factors need to be considered. Cardiogenic shock cs is defined as persistent hypotension and tissue hypoperfusion due to cardiac dysfunction in the presence of adequate intravascular volume and left ventricular filling pressure.
Cardiogenic shock cs a state of endorgan hypoperfusion due to cardiac failure zevidence of hypoperfusion zcold clammy skin feethand zcloudy consciousness zoliguria zsystolic bp cardiogenic shock. He is agitated upon presentation and is unable to give any history. Department of cardiology current management issues of cardiogenic shock gopal c ghosh unit1 2. Reconsidering vasopressors for cardiogenic shock chest. Cardiogenic shock complicating an acute coronary syndrome is observed in up to 10% of patients and is associated with high mortality still approaching 50%. In this lesson we will have cardiogenic shock explained full so you have a. A 65yearold man with longstanding hypertension developed cardiogenic shock due to the onset of left ventricular outflow obstruction and severe mitral regurgitation after surgical repair for abdominal aortic aneurysm. Cardiogenic shock is a condition in which your heart suddenly cant pump enough blood to meet your bodys needs. Cardiogenic shock journal of the american heart association. Unfortunately, there has been little progress in reducing time to hospital presentation over the past decade, 4 and this perhaps accounts for the stagnant incidence of cardiogenic shock in community studies 7. A smaller infarct may also originate this condition in a patient with a previously compromised ventricle function. Despite recent advances in treatment, nearly 50% of patients with cardiogenic shock still do not survive to hospital discharge. Acute myocardial infarction mi with left ventricular lv dysfunction is the most frequent cause of cs. Most people who have cardiogenic shock need extra oxygen.
Nutrition, mobilization, prophylaxis against dvtulcers 6. Cardiogenic shock is a condition of inadequate tissue perfusion due to decreased cardiac output. Early revascularization, vasopressors and inotropes, fluids, mechanical circulatory support, and general intensive care measures. The most common insult for cardiogenic shock is left ventricular pump failure in the setting of acute myocardial infarction. Refractory cardiogenic shock, with tissue hypoperfusion despite vasoactive medications and treatment of the underlying cause, is associated with inhospital mortality rates ranging from 30% to 50%. Cardiogenic shock is characterized by both systolic and diastolic dysfunction decreased coronary perfusion pressure and increased myocardial oxygen demand play a. Cardiogenic shock cs and pulmonary edema are lifethreatening high acuity conditions that require treatment as medical emergencies, usually in an intensive. The pathophysiology of cs is incompletely understood but limited clinical trial experience suggests that early and robust support of the failing heart to allow for restoration of systemic homoeostasis appears. Cardiogenic shock cs is a common cause of mortality, and management remains challenging despite advances in therapeutic options. If treated immediately, about half the people who develop the condition survive.
The definition, pathophysiology, and diagnosis of cardiogenic shock are presented. Presentation slides powerpoint presentation slides pdf bedside checklist download pdf validation studies. Cardiogenic shok some notes develops in 10% to 20% of patients hospitalized ami mortality of such patients approximately 80% or higher very few patients develop shock immediately after ami about half of the patients develop shock within 24h pathology clinical signs ecg shows the pattern of ami or acute coronary insufficiency the sbp cardiogenic shock immediate causes cardiogenic shock occurs if the heart suddenly cant pump enough oxygenrich blood to the body. Prev view hires image download powerpoint slide next. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. Cardiogenic shock can be a major and frequently fatal, complication of both acute and chronic disorders that aaect the function of heart to maintain adequate tissue perfusion. Cardiogenic shock and pulmonary edema harrisons principles. The choice of patients for and results of circulatory support using the intraaortic balloon pump followed by early cardiac surgery are presented. It is a frequently fatal complication of a variety of disorders, occurring most commonly following acute myocardial infarction. Treatment is to assure adequate right sided filling pressure and adequate lv preload. The condition is most often caused by a severe heart attack.
Find powerpoint presentations and slides using the power of, find free presentations research about cardiogenic shock pharmacological management ppt. Although cardiogenic shock is not common, it does complicate 710% of patients with stemi and 3% of nstemis. Cardiogenic shock diagnosis and treatment mayo clinic. Management of cardiogenic shock european heart journal. It usually takes a considerable area of infarcted myocardium around 40% to lead to cardiogenic shock. Find powerpoint presentations and slides using the power of, find free presentations research about shock types of shock ppt. Background cardiogenic shock cs is a multifactorial, hemodynamically complex syndrome associated with high mortality. Cardiogenic shock is rare, but its often fatal if not treated immediately. Cardiogenic shock cs is the most important cause of death in patients admitted with acute myocardial infarction. One of the treatment is to increase the vascular resistance,but it will add up the afterload of the heart,which means the blood will flow slowly.
Even after narrowing the diagnosis to cardiogenic shock, the list of possible etiologies is vast and the cause important to determine because the source of the shock will respond differently to different treatments. Scientific statements and publications have recommended the use of vasoconstrictors as the firstline pharmacologic choice for most cases of cardiogenic shock cs, without the abundance of strong clinical evidence. Cardiogenic shock develops as a result of the failure of the heart in its. Arguably, the single most important historical advancement was the shock should we emergently revascularize occluded coronaries for cardiogenic shock.
1168 286 916 670 812 1061 521 1030 796 989 145 1223 1209 1078 412 552 300 465 725 1539 1356 1531 869 1466 301 1404 854 1366 1213 631 793 1197 685 673 102