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Rt heart cath to diagnose the etiology of shock

Use of Right Heart Catheterization to Diagnose the Etiology of Shock

DiagnosisPAOPT SVRMiscellaneous Comments
Cardiogenic shock    
   Cardiogenic shock due to myocardial dysfunctionUsually extensive infarction (>40% of left ventricle), severe cardiomyopathy, or myocarditis
   Cardiogenic shock due to mechanical defects    
      Acute ventricular septal defectOxygen "step-up" at RV level
      Acute mitral regurgitationForward T V waves in Paop tracing
    
      RV infarctionNormal or Elevated RA and RV filling pressures with low or normal Paop
Extracardiac obstructive forms of shock    
   Pericardial tamponade Or RA mean, RV end-distolic pulmonary capillary wedge mean pressures are elevated and within 5 mm Hg of one another
   Massive pulmonary embolismNormal or Usual finding is elevated right-side pressures
Hypovolemic shock 
Distributive forms of shock    
   Septic shock Or normal Or normal, rarely  
   Anaphylactic shock Or normal Or normal 

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