Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 121

Clinically, RV-related shock leads to a high JVP and clear lungs, whereas LV-related shock leads to a high JVP with pulmonary edema. PCWP is frequently increased in RV shock, with a mean PCWP of 23 mmHg, because of concomitant LV failure and RV/ LV interdependence.¹⁰¹

When a patient with inferior MI develops cardiogenic shock, consider the following:

 RV shock

 Mechanical complication

 Relative sinus bradycardia or AV block

 Prior MI or LV dysfunction

 Superdominant RCA with apical, posterior, or lateral involvement

In the SHOCK trial and registry, ~60% of patients with LV shock had anterior MI, while 34% had inferior MI without any acute anterior involvement.^73,102 Concerning the latter 34% of patients, 14% had prior MI and 11% had concomitant apical, posterior or lateral involvement, while only 9% had isolated, new inferior MI.¹⁰²