Echocardiographic assessment in cardiogenic shock

Asian Pacific Society of Cardiology Consensus Statements on the Diagnosis and Management of Acute MI-Cardiogenic Shock and Endorsed by the Asian Pacific Society of Interventional Cardiology

“…The echocardiogram is considered one of the most useful tools to assess CS. [8][9][10][11] Aside from providing information on cardiac output, which is needed to determine the cardiac index, this modality provides information regarding ventricular function (e.g. reduction in left ventricular [LV] function or right ventricular [RV] infarction), valvular function (e.g.…”

“…Furthermore, normal LV and RV systolic function, normal cardiac chamber dimensions, absence of any significant valvular pathology and absence of any pericardial effusion may rule out a cardiac cause of shock. [8][9][10][11] Haemodynamic assessment via PAC is also suggested in patients with on-going AMI-CS. PAC provides important prognostic and predictive haemodynamic information, may distinguish right ventricular shock, as well as aids in the assessment of volume status and adequacy of resuscitation.…”

Hemodynamic monitoring in cardiogenic shock

“…A basic assessment of left and right ventricular contractility can help support or refute the diagnosis of cardiogenic shock, as well as identify emergent life-threatening etiologies of shock such as cardiac tamponade. More detailed examination can assess right and left heart geometry, quantify diastolic dysfunction, reveal regional wall motion abnormalities (suggestive of coronary artery disease), acute or chronic valvular abnormalities, outflow obstruction, as well as mechanical complications such as septal or ventricular free wall rupture, papillary muscle rupture, or chordae tendineae rupture [20 ▪ ,21]. Echocardiography can also be used to noninvasively estimate cardiac output, pulmonary artery systolic pressure and via calculation, systemic vascular resistance [22].…”