Navigating Cardiogenic Shock and Atrial Fibrillation

Take Home Points:

• Know clinical (cold extremities, oliguria, confusion, dizziness, narrow pulse pressure) and laboratory markers (metabolic acidosis, elevated creatinine, lactic acidosis) of hypoperfusion.

• An elevated lactate is a danger sign and requires explanation.

• Norepinephrine is a great first line vasopressor in Cardiogenic shock.

• Dobutamine is useful for inotropic support in Cardiogenic shock.

• Use POCUS in ED. In addition to echo and VTI for cardiac output, use IVC assessment for central venous pressure/volume status.

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