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Şocul cardiogenic

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 Şocul cardiogenic-etiologie Şocul cardiogenic- etiologie Contractilitatea: Contractilitatea: IMA IMA Anevrism VS Anevrism VS Cardiomiopatie Cardiomiopatie Contuzie miocardică Contuzie miocardică Miocardită acută Miocardită acută Disfuncţie VS (toxice, drouri! Disfuncţie VS (toxice, drouri! Aritmie" #A V Aritmie" #A V

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  • ocul cardiogenic-etiologieContractilitatea:IMAAnevrism VSCardiomiopatie Contuzie miocardicMiocardit acutDisfuncie VS (toxice, droguri)Aritmie/ BAV

  • ocul cardiogenic- etiologieProbleme mecanice:PostsarcinRegurgitare mitral acut prin ruptur/disfuncie de muchi capilariSAoCMHDisecie de aortRuptur de sept ventricularPresarcinStenoz mitralMixom atrialEmbolie pulmonar masivRuptur de sept ventricularRuptur de cord cu tamponadDisecie de aort cu tamponad pericardicTamponad pericardic

  • FiziopatologieClase IMA:I- DC normal + presarcin normal- mortalitate 3 %II- DC normal + edem pulmonar (vasodilatatoare, diuretice)- mortalitate 9 %III- DC sczut, presarcin normal (volum, inotrop pozitiv)- mortalitate 23 %IV- DC sczut, presarcin crescut- mortalitate > 50 %

  • Tablou clinicSemnele afeciunii cardiace: durere anginoas, dispnee, astenieSemne de oc: hipoperfuzie, hTA, tahicardie, stimulare simpatic compensatorie, oligurieSemne de insuficien ventricular stng acut i de insuficien ventricular dreapt acut

  • DiagnosticExamen fizicEcg 12 derivaiiRadiografie toracic- suprancrcare pulmonar, ICT Gaze arterialeEnzime miocardiceEcocardiografie transtoracic i transesofagianMonitorizare hemodinamic invaziv

  • TratamentAfeciuni cardiace: tromboliz, PTCA, chirurgie cardiovascularEPA: ventilaie mecanic, vasodilatatoare, diureticeSuport inotrop pozitiv: dopamin, dobutamin, balon de contrapulsaie aorticIntervenii chirurgicale n urgen


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