cardio - veronica92

[ArchivalUser]

S 51 yr old man is undergoing abdominal surgery and becomes hypotensive while under general anesthesia. The patient had been doing well during most of the procedure but now has a blood pressure of 80/40 mm of Hg. His past medical history is significant for coronary artery disease and diabetes mellitus. A pulmonary artery catheter placed prior to the procedure gives the folowing data:
Central venous pressure 10mmHg
Pulmonary artery pressure60/30mmHg
Pulmonary capillary occlusion pressure 24mm Hg
Cardiac output 2.3L/min

Which of the following is the most likely diagnosis?
a acute left heart failure
b Acute mitral regurgitation
c. Acute right heart failure
d Hypoxic pulmoary vasoconstriction
e Sepsis syndrome

[ArchivalUser]

Normal CVP is 2-6 mm Hg . in this case it is elevated which may indicate Rt heart pathology or increased pressure in the pulmonary artery( which is elevated here]. DDD

[ArchivalUser]

I think D may be a 2ndary to C + Hx of CAD + DM --So I say C

[ArchivalUser]

CC

[ArchivalUser]

The ans is a..the pat has high filling pressure and low cardiac output..thereby indicating cardiogenic shock. Cardiogenic shock could be due to a variety of reasons but the end result is left ventricular failure. This accounts for the secondarily high right sided pressures and filling pressures( left sided failure causes right sided failure).

[ArchivalUser]

a... just look for Pulmonary capillary occlusion pressure 24mm Hg... which is high. so cardiogenic shoch , here, it is dueo to LVF.

[ArchivalUser]

is Pulm Cappilary occlusion pressure sam as PCWP?