Cardionerds: A Cardiology Podcast

168. CCC: Cardiogenic Shock – Initial Assessment and The Shock Team Call with Dr. Anu Lala

4 snips
Dec 21, 2021
Dr. Anu Lala, a leading expert in advanced heart failure, dives into the intricacies of cardiogenic shock. She discusses the essential protocols for initial assessment and the importance of a Shock Team in providing optimal care. The conversation highlights the collaboration among specialists for comprehensive evaluations and emphasizes recognizing patients as unique individuals. Dr. Lala also addresses the emotional and ethical dimensions of managing critical cases, offering insights into the profound human experience of healthcare.
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INSIGHT

Clinical Definition And Hemodynamic Criteria

  • Cardiogenic shock is defined by hypotension, end-organ hypoperfusion, and specific hemodynamics.
  • Classic hemodynamic cutoffs include CI ≤2.2 L/min/m2 and PCWP ≥15 mmHg alongside clinical hypoperfusion.
ADVICE

Start With A Focused Bedside Exam

  • Do a focused bedside exam and build a human connection while assessing the patient.
  • Use pulses, temperature, JVP, PMI, heart sounds, and hourly urine output to evaluate perfusion and congestion.
ADVICE

Prioritize Trends Over Single Measurements

  • Track trends in urine output, lactate, and blood pressure rather than relying on single values.
  • Trends better reflect response to therapy and the patient's true trajectory in shock.
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