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Unmasking right ventricular failure in cardiogenic shock: The importance of serial hemodynamics
Author(s) -
Lemor Alejandro,
AlDarzi Waleed,
O'Neill William,
Basir Mir Babar
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29493
Subject(s) - cardiogenic shock , impella , medicine , hemodynamics , cardiology , shock (circulatory) , cardiac catheterization , circulatory system , myocardial infarction
A 65‐year‐old female was transferred with myocardial infarction, three‐vessel coronary artery disease, cardiogenic shock and an intraaortic balloon pump. Given persistent shock, mechanical circulatory support (MCS) was upgraded using a left ventricular hemodynamic support device (Impella CP). The patient was monitored in the catheterization laboratory and serial hemodynamic measures were obtained. Initial hemodynamics showed relative improvement; however, serial assessments demonstrated worsening hemodynamics secondary to right ventricular failure, ultimately requiring a right ventricular hemodynamic support device. The case highlights the rapid changes that can occur with mechanical circulatory support devices and demonstrates the importance of obtaining serial hemodynamics in the cardiac catheterization laboratory.