Cardiogenic shock diagnostic criteria: Difference between revisions

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__NOTOC__
__NOTOC__
{{Cardiogenic shock}}
{{Cardiogenic shock}}
{{CMG}}; {{AE}} {{AZ}} {{JS}}
{{CMG}}; {{AE}} {{AZ}}; {{JS}}; {{Rim}} {{sali}}


==Overview==
==Overview==
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===Clinical Criteria===
===Clinical Criteria===


* Sustained [[hypotension]] for at least 30 minutes defined as [[systolic blood pressure]] <90 mm Hg, or [[systolic blood pressure]] 30 mm Hg below baseline in preexisting [[hypertension]], or the need for supportive measures to keep the [[systolic blood pressure]] >90 mmHg
* Sustained [[hypotension]] for at least 30 minutes defined as [[systolic blood pressure]] <90 mmHg, or [[mean arterial pressure]] 30 mmHg below baseline in preexisting [[hypertension]], or the need for supportive measures to keep the [[systolic blood pressure]] >90 mmHg
* Clinical evidence of [[hypoperfusion|tissue hypoperfusion]] as manifested by [[oliguria]] (urine output <30 mL/hour), [[cyanosis]], [[cool extremities]], or [[Altered mental status|altered mental status]]
* Clinical evidence of [[hypoperfusion|tissue hypoperfusion]] as manifested by [[oliguria]] (urine output <30 mL/hour), [[cyanosis]], [[cool extremities]], or [[Altered mental status|altered mental status]]
* Presence of [[myocardial]] dysfunction following exclusion or correction of possible non-[[myocardial]] factors contributing to [[hypoperfusion|tissue hypoperfusion]] such as [[hypovolemia]], [[hypoxia]], [[arrhythmia]], and [[acidosis]]<ref name="Califf-1994">{{Cite journal  | last1 = Califf | first1 = RM. | last2 = Bengtson | first2 = JR. | title = Cardiogenic shock. | journal = N Engl J Med | volume = 330 | issue = 24 | pages = 1724-30 | month = Jun | year = 1994 | doi = 10.1056/NEJM199406163302406 | PMID = 8190135 }}</ref><ref name="Hollenberg-1999">{{Cite journal  | last1 = Hollenberg | first1 = SM. | last2 = Kavinsky | first2 = CJ. | last3 = Parrillo | first3 = JE. | title = Cardiogenic shock. | journal = Ann Intern Med | volume = 131 | issue = 1 | pages = 47-59 | month = Jul | year = 1999 | doi =  | PMID = 10391815 }}</ref><ref name="Goldberg-1991">{{Cite journal  | last1 = Goldberg | first1 = RJ. | last2 = Gore | first2 = JM. | last3 = Alpert | first3 = JS. | last4 = Osganian | first4 = V. | last5 = de Groot | first5 = J. | last6 = Bade | first6 = J. | last7 = Chen | first7 = Z. | last8 = Frid | first8 = D. | last9 = Dalen | first9 = JE. | title = Cardiogenic shock after acute myocardial infarction. Incidence and mortality from a community-wide perspective, 1975 to 1988. | journal = N Engl J Med | volume = 325 | issue = 16 | pages = 1117-22 | month = Oct | year = 1991 | doi = 10.1056/NEJM199110173251601 | PMID = 1891019 }}</ref>
* Presence of [[myocardial]] dysfunction following exclusion or correction of possible non-[[myocardial]] factors contributing to [[hypoperfusion|tissue hypoperfusion]] such as [[hypovolemia]], [[hypoxia]], [[arrhythmia]], and [[acidosis]]<ref name="Califf-1994">{{Cite journal  | last1 = Califf | first1 = RM. | last2 = Bengtson | first2 = JR. | title = Cardiogenic shock. | journal = N Engl J Med | volume = 330 | issue = 24 | pages = 1724-30 | month = Jun | year = 1994 | doi = 10.1056/NEJM199406163302406 | PMID = 8190135 }}</ref><ref name="Hollenberg-1999">{{Cite journal  | last1 = Hollenberg | first1 = SM. | last2 = Kavinsky | first2 = CJ. | last3 = Parrillo | first3 = JE. | title = Cardiogenic shock. | journal = Ann Intern Med | volume = 131 | issue = 1 | pages = 47-59 | month = Jul | year = 1999 | doi =  | PMID = 10391815 }}</ref><ref name="Goldberg-1991">{{Cite journal  | last1 = Goldberg | first1 = RJ. | last2 = Gore | first2 = JM. | last3 = Alpert | first3 = JS. | last4 = Osganian | first4 = V. | last5 = de Groot | first5 = J. | last6 = Bade | first6 = J. | last7 = Chen | first7 = Z. | last8 = Frid | first8 = D. | last9 = Dalen | first9 = JE. | title = Cardiogenic shock after acute myocardial infarction. Incidence and mortality from a community-wide perspective, 1975 to 1988. | journal = N Engl J Med | volume = 325 | issue = 16 | pages = 1117-22 | month = Oct | year = 1991 | doi = 10.1056/NEJM199110173251601 | PMID = 1891019 }}</ref>
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===Hemodynamic Criteria===
===Hemodynamic Criteria===


* Sustained [[hypotension]] for at least 30 minutes defined as [[systolic blood pressure]] <90 mm Hg, or [[systolic blood pressure]] 30 mm Hg below baseline in preexisting [[hypertension]], or the need for supportive measures to keep the [[systolic blood pressure]] >90 mmHg
* Sustained [[hypotension]] for at least 30 minutes defined as [[systolic blood pressure]] <90 mmHg, or [[mean arterial pressure]] 30 mmHg below baseline in preexisting [[hypertension]], or the need for supportive measures to keep the [[systolic blood pressure]] >90 mmHg
* Depressed [[cardiac index]] (&lt;1.8 L/min/m<sup>2</sup> of [[body surface area|BSA]] without support or &lt;2.0–2.2 L/min/m<sup>2</sup> of [[body surface area|BSA]] with support)
* Depressed [[cardiac index]] (&lt;1.8 L/min/m<sup>2</sup> of [[body surface area|BSA]] without support or &lt;2.0–2.2 L/min/m<sup>2</sup> of [[body surface area|BSA]] with support)
* Elevated [[PCWP|pulmonary capillary wedge pressure]] (&gt;15 mm Hg)
* Elevated [[PCWP|pulmonary capillary wedge pressure]] (&gt;15 mm Hg)

Latest revision as of 19:32, 10 December 2019

Cardiogenic Shock Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cardiogenic shock from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Zaghw, M.D. [2]; João André Alves Silva, M.D. [3]; Rim Halaby, M.D. [4] Syed Musadiq Ali M.B.B.S.[5]

Overview

Cardiogenic shock is the presence of tissue hypoperfusion secondary to decreased cardiac output in the context of adequate intravascular volume.

Diagnostic Criteria

Clinical Criteria

Hemodynamic Criteria

References

  1. 1.0 1.1 Califf, RM.; Bengtson, JR. (1994). "Cardiogenic shock". N Engl J Med. 330 (24): 1724–30. doi:10.1056/NEJM199406163302406. PMID 8190135. Unknown parameter |month= ignored (help)
  2. Hollenberg, SM.; Kavinsky, CJ.; Parrillo, JE. (1999). "Cardiogenic shock". Ann Intern Med. 131 (1): 47–59. PMID 10391815. Unknown parameter |month= ignored (help)
  3. 3.0 3.1 Goldberg, RJ.; Gore, JM.; Alpert, JS.; Osganian, V.; de Groot, J.; Bade, J.; Chen, Z.; Frid, D.; Dalen, JE. (1991). "Cardiogenic shock after acute myocardial infarction. Incidence and mortality from a community-wide perspective, 1975 to 1988". N Engl J Med. 325 (16): 1117–22. doi:10.1056/NEJM199110173251601. PMID 1891019. Unknown parameter |month= ignored (help)
  4. Forrester, JS.; Diamond, G.; Chatterjee, K.; Swan, HJ. (1976). "Medical therapy of acute myocardial infarction by application of hemodynamic subsets (first of two parts)". N Engl J Med. 295 (24): 1356–62. doi:10.1056/NEJM197612092952406. PMID 790191. Unknown parameter |month= ignored (help)
  5. Forrester, JS.; Diamond, G.; Chatterjee, K.; Swan, HJ. (1976). "Medical therapy of acute myocardial infarction by application of hemodynamic subsets (second of two parts)". N Engl J Med. 295 (25): 1404–13. doi:10.1056/NEJM197612162952505. PMID 790194. Unknown parameter |month= ignored (help)
  6. Reynolds, HR.; Hochman, JS. (2008). "Cardiogenic shock: current concepts and improving outcomes". Circulation. 117 (5): 686–97. doi:10.1161/CIRCULATIONAHA.106.613596. PMID 18250279. Unknown parameter |month= ignored (help)


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