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Shock Cardiogenic shoc1

Shock Cardiogenic shoc1 - • Treatment = Thrombolysis...

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Shock Cardiogenic shock Cardiogenic shock is based upon an inadequate circulation of blood due to primary failure of the ventricles of the heart to function effectively Clinical Features of Cardiogenic Shock Reduced contractility (usually) due to ischaemia and infarction of myocardium Low cardiac output – a features of shock High LVEDP (Left ventricular end diastolic pressure) o Pulmonary congestion - Dyspnoea, hypoxaemia, crackles and wheezes in the chest o Pulmonary oedema and pleural effusion o Right ventricular failure - Raised JVP and dependant oedema Management of Cardiogenic Shock Diagnosis - History of IHD, chest pain, ECG, troponin, enzymes
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Unformatted text preview: • Treatment = Thrombolysis , Angiography (PTCA and stenting), Supportive measures (Oxygenation, filling, cardiac support). Supportive Measures for Cardiogenic Shock • Oxygenation o High concentration oxygen mask o CPAP (Continuous Positive Airway Pressure) o IPPV (Intermittent positive pressure ventilation) • Filling o IV fluids, guided by by CVP, PCWP, TOE • Pharmacological circulatory support o Beta 1 adrenoceptor agonists increasing contractility o Alpha 1 agonists increasing vasoconstiction o Phosphodiesterase inhibitors reducing vasoconstriction • Mechanical support • IABP (Intra-aortic Balloon Pump)...
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