[Acute heart failure: acute cardiogenic pulmonary edema and cardiogenic shock]. / Formas de presentación de la insuficiencia cardíaca aguda: edema agudo de pulmón y shock cardiogénico.
Med Clin (Barc)
; 142 Suppl 1: 14-9, 2014 Mar.
Article
in Es
| MEDLINE
| ID: mdl-24930078
ABSTRACT
Acute cardiogenic pulmonary edema and cardiogenic shock are two of the main forms of presentation of acute heart failure. Both entities are serious, with high mortality, and require early diagnosis and prompt and aggressive management. Acute pulmonary edema is due to the passage of fluid through the alveolarcapillary membrane and is usually the result of an acute cardiac episode. Correct evaluation and clinical identification of the process is essential in the management of acute pulmonary edema. The initial aim of treatment is to ensure hemodynamic stability and to correct hypoxemia. Other measures that can be used are vasodilators such as nitroglycerin, loop diuretics and, in specific instances, opioids. Cardiogenic shock is characterized by sustained hypoperfusion, pulmonary wedge pressure > 18 mmHg and a cardiac index < 2.2l/min/m(2). The process typically presents with hypotension (systolic blood pressure < 90 mmHg or a decrease in mean arterial pressure > 30 mmHg) and absent or reduced diuresis (< 0.5 ml/kg/h). The most common cause is left ventricular failure due to acute myocardial infarction. Treatment consists of general measures to reverse acidosis and hypoxemia, as well as the use of vasopressors and inotropic drugs. Early coronary revascularization has been demonstrated to improve survival in shock associated with ischaemic heart disease.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pulmonary Edema
/
Shock, Cardiogenic
/
Heart Failure
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Screening_studies
Limits:
Humans
Language:
Es
Journal:
Med Clin (Barc)
Year:
2014
Document type:
Article