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CARDIOGENIC SHOCK
• Definition
• Etiology
• Pathophysiology
• Clinical features
• Monitoring
• Positive şi etiological diagnosis
• Differential diagnosis
• Principles of treatment
DEFINITION
Hypovolemic ↑ ↓ ↓ ↓ ↓ ↑ ↑ ↓
shock
Cardiogenic ↑ ↓↓ ↓ ↑ ↑ ↑ ↑ ↓
shock
septic shock ↑ ↓ ↑N ↓N N ↓ ↓ ↑
PRINCIPLES OF TREATMENT
• early and aggresive treatment –
save time
• Save functional myocardium
Myocardial reperfusion
PRINCIPLES OF TREATMENT
• Improvement of the myocardial oxygen supply
-demand relationship
• ↑ myocardial oxygen supply
• Hypoxemia correction – O2 therapy, ventilator support (CPAP, PEEP)
• Hypotension correction – volemic therapy
vasoconstrictors
• Improvement of cardiac output - inotropic agents
↓ myocardial oxygen demand
• Treatment of pain – opioid analgesics
• Treatment of cardiac dysrhytmias – cardioversion
antiarrhytmic agents
pacing
• myocardial reperfusion
– Thrombolysis
– PTCA
– Cardiac surgery: emergency coronary artery by-pass
correction of mechanical defects
cardiac transplant
CONCLUSIONS