Cardiovascular Medicine Book

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Cardiogenic ShockAka: Acute Pulmonary Edema Management, Congestive Heart Failure Exacerbation Management

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  1. See Also
    1. Pulmonary Edema
    2. Congestive Heart Failure
    3. Congestive Heart Failure Exacerbation Decision Rule
    4. Heart Failure Causes
    5. Diastolic Dysfunction
    6. Systolic Dysfunction
  2. Indications
    1. Acute Pulmonary Edema secondary to CHF exacerbation
  3. Management: Initial
    1. Furosemide (Lasix) 0.5 to 1.0 mg/kg IV
    2. Morphine 2 to 4 mg IV
    3. Nitroglycerin 0.4 mg SL
    4. Oxygen (with advanced airway management as needed)
  4. Management: Next
    1. Systolic Blood Pressure over 100 mmHg
      1. Nitroglycerin 10 to 20 ug/min IV
      2. Consider Nitroprusside 0.1 to 5.0 ug/kg/min IV
      3. Consider Dobutamine 2 to 20 ug/kg/min IV if no shock
      4. Consider Nesiritide (Natrecor) in refractory cases
    2. Systolic Blood Pressure 70 to 100 mmHg
      1. Dopamine 5 to 15 ug/kg/min IV
  5. Management: Additional Options
    1. Pulmonary artery catheter
    2. Intra-aortic balloon pump
    3. Coronary angiogram
  6. Prognosis
    1. Congestive Heart Failure Exacerbation Decision Rule
  7. References
    1. Ryan (2001) CMEA Internal Medicine Lecture, San Diego
    2. (2000) Circulation 102(suppl I):I

Shock, Cardiogenic (C0036980)

Definition (MSH)Shock resulting from diminution of cardiac output in heart disease.
Definition (CSP)shock reulting from the failure of the heart to maintain adequate output.
Definition (NCI)Shock resulting from primary failure of the heart in its pumping function, as in myocardial infarction, severe cardiomyopathy, or mechanical obstruction or compression of the heart.
Definition (NCI)Shock resulting from primary failure of the heart in its pumping function, as in myocardial infarction, severe cardiomyopathy, or mechanical obstruction or compression of the heart.
ConceptsPathologic Function (T046)
ICD9785.51
MSHD012770
Englishcardiocirculatory collapse, Cardiogenic Shock, SHOCK CARDIOGENIC
Spanishchoque cardiogeno, shock cardiogeno
Parent Conceptshypotension and shock (C0679394), Circulatory system disease NOS (C0728936), Shock (C0036974), heart output disorder (C0596677), [D]Shock without mention of trauma NOS (C0159051), Myocardial Infarction (C0027051), Cardiovascular Diseases (C0007222), Duplicate concept (C1274013)
SourcesAOD, CSP, CST, DXP, ICD9CM, LCH, MSH, NCI, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Acute congestive heart failure (C0264719)

ConceptsDisease or Syndrome (T047)
EnglishAcute congestive heart failure
Spanishfallo cardiaco congestivo agudo, insuficiencia cardiaca congestiva aguda
Parent ConceptsCongestive heart failure (C0018802), Acute heart failure (C0264714), Duplicate concept (C1274013)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Acute cardiac pulmonary edema (C0398350)

ConceptsDisease or Syndrome (T047)
EnglishAcute cardiac pulmonary edema, Acute cardiac pulmonary oedema, Acute cardiogenic pulmonary edema, Acute cardiogenic pulmonary oedema, Cardiogenic pulmonary edema, Cardiogenic pulmonary oedema
Spanishedema pulmonar agudo por causa cardiaca, edema pulmonar cardiogenico
Parent ConceptsAcute pulmonary edema unspecified (C0155919), Ambiguous concept (C1274012)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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