Acute heart failure with shock

Hemodynamics

  • BP ≤ 90 mmHg or MAP ≤ 60 mm Hg (SBP 2/3 + 1/3 DBP).
  • HR ≥ 120 bpm.
  • Peripheral hypoperfusion, marbling, oligoanuria.

Respiration

  • Tachypnoea.
  • Suprasternal Draw.
  • Swing thoracoabdominal.
  • Sweats, sometimes bradypnea <10 / min.

Monitoring

  • BP, T°, Sp O2
  • HR, RF

Examinations to achieve once initiated treatment.

  • ECG
  • Chest X-ray
  • Echocardiography._
  • Labo (FSS, Na, K, BNP, urea, creatinine, AST, ALT, GGT, troponin, glucose) BNP is usually> 400pg / ml in patients with heart failure. If <100 pg / mL, consider an alternative diagnosis - Non-invasive test for ischemia, coronary angiography).
  • Search for arrhythmia (ECG, Holter, ET)
  • Search for alcohol or drugs.
  • Drug review (chemotherapy, antidepressants, phenothiazines, anti TNF).
  • Balance infectious (VIH, Borreliose, Cocksakie, Chagas, jellyfish, snakes, scorpions).

Treatment