Report of a complicated patient with cardiogenic shock (related complications and treatment processes)

Kazrani, H and Godini, A A (2007) Report of a complicated patient with cardiogenic shock (related complications and treatment processes). J Urmia Nurs Midwifery Fac. 2007; 5 (4) :9-28, 5 (4). pp. 9-28.

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Abstract

Conventional therapy for cardiogenic shock with coronary care unit monitoring and vasopressor agents to support blood pressure has historically been associated with an 80% to 90% mortality rate in large series. In addition to acute myocardial infarction severe heart valves insufficiency can cause cardiogenic shock too. hemorrhagic shock may be developed more rapidly if bleeding accompanied with coagulation disorders. Rise in extra cellular potassium concentration can cause heart weakness and dysrhythmia. How about that if all of these take place at same time. A 78 years old man was admitted with dyspnea from a few days ago. He had history of myocardial infarction. Cardiomegaly was seen in his chest X ray scan and had moderate mitral regurgitation and aortic valve insufficiency in last echocardiography. In electrocardiogram his cardiac rhythm was atrial fibrillation with slow ventricular response and left bundle branch block was seen. He developed cardiogenic shock that led to cardiac arrest. After 45 minutes cardiopulmonary resuscitation he was connected to ventilator because he had not spontaneous respiration and was in deep coma. His heart rate was 40 b/min and blood pressure was not detected. After a few hours gastro intestinal bleeding and hematuria was happened while he had coagulation disorder too (PT=31.5 seconds ,PTT>120 seconds). Also he had severe hyperkalemia. All of them took place in 6 hours. But this patient has been recovered and discharged in a few days. We want to explain how common cares and treatments for a patient that had little chance to survive and needed intensive care had good efficiency

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