Aashi
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A 63-year-old woman is admitted to the hospital after an acute inferior myocardial infarction.
She is noted to be oliguric, and has a blood pressure of 80/55 mm Hg. A Swan-Ganz catheter
is placed, revealing a diminished pulmonary capillary wedge of 4 mm Hg, normal pulmonary
artery pressure of 22/4 mm Hg, and an increased mean right atrial pressure of 11 mm Hg.
Which of the following is the most appropriate next step in management?
A. Balloon angioplasty
B. Digoxin
C. Fluids
D. Intraaortic balloon counterpulsation
E. Vasopressors
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| robin082006
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C
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| AAzad
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C. fluids
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| hallachi
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in the Q the pt is in cardiogenic shock ..in my opinion why not we give Digoxin ...bcoz the blood is not going in to systemic circulation and the reason is the heart did not pump properly ..if u give fluids it will not give benefits bcoz heart is not pumping blood to the system..
correct me if i am wrong..
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| Aashi
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Hallachi ,in cardiogenic shock PCWP is increased >25..here its 4....
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| jvo_md
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c is the initial answer...if fluids don't work, then you use vasopresors.
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| hallachi
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JVO-MD and robbins please explain ur ans..
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| AAzad
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in case of right Mi the best initial treatment for this condition is Flouid
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| s2006
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initial step is fluids.
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