Cardiovascular Emergencies Flashcards

A patient in cardiogenic shock has cold extremities, hypotension, and pulmonary congestion. Which hemodynamic profile is expected?

Answer: Low CO, high PCWP, high SVR

Cardiogenic shock features low cardiac output, elevated filling pressures (PCWP), and compensatory high systemic vascular resistance.

Which medication is a first-line inotrope for a patient in cardiogenic shock with adequate blood pressure?

Answer: Dobutamine

Dobutamine improves contractility and cardiac output and is preferred when blood pressure is marginally adequate.

How does an intra-aortic balloon pump improve cardiac function in cardiogenic shock?

Answer: It increases coronary perfusion during diastole and reduces afterload during systole

The IABP inflates in diastole to augment coronary perfusion and deflates in systole to reduce afterload.

A patient with acute decompensated heart failure has an SpO2 of 84% and crackles throughout. What is the priority intervention?

Answer: Provide supplemental oxygen and consider noninvasive positive pressure ventilation

Oxygenation and positive pressure ventilation improve gas exchange and reduce preload in acute pulmonary edema.

Which sign distinguishes right-sided heart failure from left-sided heart failure?

Answer: Jugular venous distention and peripheral edema

Right-sided failure causes systemic venous congestion with JVD and peripheral edema, whereas left-sided failure causes pulmonary symptoms.

A heart failure patient's BNP is markedly elevated. What does this indicate?

Answer: Increased ventricular wall stretch and volume overload

BNP is released in response to ventricular stretch, so elevation reflects volume overload and heart failure severity.

Why are ACE inhibitors a cornerstone of chronic heart failure management?

Answer: They reduce afterload and prevent ventricular remodeling

ACE inhibitors lower afterload and inhibit the RAAS, slowing maladaptive ventricular remodeling.