Summary
Summary Cardio Exam 3 EMSOP
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- Rutgers University
Everything you need to know, except GOW for cardio final exam 3
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BP = CO x SVRCO = SV x HR
↑preload → ↑SV
↑afterload → ↓SV
Hypotension = systolic <90 OR reduction for 40mmHg from baseline OR MAP <65mmHg + tachycardia/↓organ perfusion
MAP: surrogate for organ perfusion + systemic pressure, takes into account diastolic filling – 2/3 DBP + 1/3 SBP
DO2 (oxygen delivery) = CO × CaO2 (arterial O2 content)
Shock: heterogeneous, acute - medical emergency, progressive, circulatory failure, demand >supply for nutrients + O2 - dysoxia (goal = restore O2)
Patho: impaired perfusion → cellular hypoxia → switch to anaerobic (pyruvate) → lactate – EVALUATE if LACTATE > 2 mmol/L
Inadequate tissue perfusion = ↓BP (hypotension - usually seen but not required) + ↓MAP (↓CO or ↑SVR)
Vitals + clinical signs Biochemical End organ damage: (IF SHE ASK # of ORGANS)
1. System artiel HoTN 6. ↑Blood lactate 1. Brain: Acute mental status
2. +/- fever 7. Abnormal cellular O2 metabolism 2. Heart: ↑HR - Tachycardia, Hypotension
3. +/- JVP 3. Lungs: Resp failure (↑RR, ↓O2 stats)
4. Skin: warm, cold, clammy, mottles, delayed capillary 4. Kidney: Oliguric renal failure (<400ml/24hr)
refill 5. Cellular: Lactic acidosis (ABG/lactate)
5. Tachycardia, tachypnea, ↑breathing work
Manifestations of ↓CO Manifestation of ↑CO
- Narrow pulse pressure - Wide pulse pressure: >40 mmHg between systolic/diastolic + LOW diastolic
- Cold, clammy, delayed refill, neck veins full - Warm, bounding pulse, brisk refill, fever, infection, sepsis
Hemodynamic measuring + - Intra-arterial catheter - MAP
monitoring: INVASIVE - Central venous catheter - CVP, preload, EDV
- Pulmonary artery catheter (Swan-Ganz) - CO/CI, SVR, RVEDVI
Preload CI/CO (heart) SVR Summary Cuase
Hypovolemic ↓ ↓ ↑ Low preload, Low CO, (↑intravascular volume) Trauma, hemorrhage
Cardiogenic ↑ ↓ ↑ Low contractility, Low CO MI, CHF, Myocarditis
Distributive/vasodilatory ↓ ↑ ↓ Low SVR Sepsis/Anaphylaxis
Obstructive ↓ ↓ ? Low preload, Low CO (obstruction LV venous return) PE, tension, tamponade
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