03-26-2014, 08:46 PM
An 84 y/o caucasian male is brought to the ER with severe chest pain, dyspnea and diaphoresis. His past medical hx is significant for a long hx of HTN and DM II. He experienced a severe MI 6 months ago. His current medications are enalapril, metoprolol, aspirin, furosemide, ptassium, glyburide and pravastatin but he says that he has not been taking some of his medications recently. Physical exam reveals acrocyanosis and symmetric 3+ lower extremity edema. Point of maximal impulse is displaced to the left and a holosystolic II/VI apical murmur is heard at the apex. Nonspecific ST segment and T wave changes are present on ECG. The initial set of cardiac enzymes are positive. The pt continues to deteriorate despite aggressive diuretic and vasodilatory Tx. You perform an Echocardiographic evaluation of the LV function and decide to proceed with pulmonary artery catheterization. Cardiac Index(CI), Total peripheral resistance(TPR) and LV end diastolic Volume (LVEDV) are determined. Which of the following is most likely to present?
A-CI decr, TPR decr, LVEDV decr
B-CI decr, TPR Incr, LVEDV decr
C-CI decr, TPR Incr, LVEDV Incr
D-CI decr, TPR Incr, LVEDV normal
E-CI normal, TPR decr, LVEDV Incr
A-CI decr, TPR decr, LVEDV decr
B-CI decr, TPR Incr, LVEDV decr
C-CI decr, TPR Incr, LVEDV Incr
D-CI decr, TPR Incr, LVEDV normal
E-CI normal, TPR decr, LVEDV Incr