Identifying cardiogenic shock in the emergency department

Autor: Madison Daly, Alex Koyfman, Brit Long, Skyler Lentz
Rok vydání: 2020
Předmět:
medicine.medical_specialty
Multiple Organ Failure
Point-of-Care Systems
Myocardial Infarction
Shock
Cardiogenic
Pulmonary Edema
Physical examination
Kidney Function Tests
Sepsis
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Liver Function Tests
Tachycardia
Natriuretic Peptide
Brain
Bradycardia
medicine
Edema
Humans
In patient
Lactic Acid
Myocardial infarction
Confusion
Intensive care medicine
Physical Examination
Heart Failure
Heart Murmurs
medicine.diagnostic_test
business.industry
Cardiogenic shock
030208 emergency & critical care medicine
General Medicine
Emergency department
medicine.disease
Peptide Fragments
Troponin
Early Diagnosis
Echocardiography
Shock (circulatory)
Emergency Medicine
Acidosis
Lactic
Hypotension
medicine.symptom
Emergency Service
Hospital
business
Clinical evaluation
Zdroj: The American Journal of Emergency Medicine. 38:2425-2433
ISSN: 0735-6757
Popis: Introduction Cardiogenic shock is difficult to diagnose due to diverse presentations, overlap with other shock states (i.e. sepsis), poorly understood pathophysiology, complex and multifactorial causes, and varied hemodynamic parameters. Despite advances in interventions, mortality in patients with cardiogenic shock remains high. Emergency clinicians must be ready to recognize and start appropriate therapy for cardiogenic shock early. Objective This review will discuss the clinical evaluation and diagnosis of cardiogenic shock in the emergency department with a focus on the emergency clinician. Discussion The most common cause of cardiogenic shock is a myocardial infarction, though many causes exist. It is classically diagnosed by invasive hemodynamic measures, but the diagnosis can be made in the emergency department by clinical evaluation, diagnostic studies, and ultrasound. Early recognition and stabilization improve morbidity and mortality. This review will focus on identification of cardiogenic shock through clinical examination, laboratory studies, and point-of-care ultrasound. Conclusions The emergency clinician should use the clinical examination, laboratory studies, electrocardiogram, and point-of-care ultrasound to aid in the identification of cardiogenic shock. Cardiogenic shock has the potential for significant morbidity and mortality if not recognized early.
Databáze: OpenAIRE
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