The CardioNerds and Dr. Javed Butler on Treating Cardiogenic Shock

By CardioNerds - Last Updated: February 14, 2024

CardioNerds intern Hirsh Elhence and CardioNerds Academy faculty member Dr. Breana Hansen are joined by expert faculty Dr. Javed Butler, of the University of Mississippi, to answer the following question related to heart failure:

Mrs. Hart is a 70-year-old woman who was admitted to the cardiac ICU 2 days prior for signs and symptoms consistent with cardiogenic shock. Since she was admitted, she has been on maximal diuretics, requiring greater doses of intravenous dobutamine. Unfortunately, her liver and renal function continue to worsen, and her urine output is decreasing. A right heart catheterization reveals elevated biventricular filling pressures with a cardiac index of 1.7 L/min/m2 by the Fick method.

What is the best next step in her care?

A Continue current measures and monitor for improvement
B Switch from dobutamine to norepinephrine
C Place an intra-aortic balloon pump
D Resume guideline-directed medical therapy

This question refers to Section 9.5 of the 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure.

*Answer is provided at 2:57.

This podcast originally appeared on The CardioNerds.

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