172. CCC: The Hemodynamic Evaluation of Cardiogenic Shock with Dr. Nosheen Reza

The CardioNerds Cardiac Critical Care Series discusses the hemodynamics of shock, focusing on invasive hemodynamic assessment using pulmonary artery catheters and the interpretation of Swan-Ganz catheter data. Experts Dr. Brian McCauley and Dr. Nosheen Reza, along with hosts, analyze a heart failure patient's journey through three admissions, emphasizing the appropriate use of PA catheters, potential complications, and the importance of accurate data collection. They review the ESCAPE trial's implications, discuss the utility of various hemodynamic parameters like cardiac power output and aortic pulsatility index, and provide a systematic approach to interpreting right heart catheter data to guide clinical management and therapeutic decisions in cardiogenic shock.

Outlines

Part 1: Introduction and Clinical Assessment

Part 2: Patient Case - Initial Assessment

Part 3: Patient Case - Subsequent Admissions and Shock

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Cardionerds: A Cardiology Podcast

Part 1: Introduction and Clinical Assessment

Introduction to Hemodynamics of Shock and the Swan-Ganz Catheter

Lessons from the ESCAPE Trial and Clinical Assessment of Hemodynamics

Accuracy of Clinical Assessment and Indications/Contraindications for PA Catheter Use

Part 2: Patient Case - Initial Assessment

Introduction to Patient Case: Mr. Gavin Swanson

Initial Hemodynamic Assessment of Mr. Swanson

Best Practices for Measuring Pressure Waveforms and Systematic Interpretation of Hemodynamics

Cardiac Output Assessment Methods and Left Ventricular Function Metrics

Aortic Pulsatility Index (API) and Right Ventricular Function Assessment

Part 3: Patient Case - Subsequent Admissions and Shock

Mr. Swanson's Second Admission: Septic Shock

Mr. Swanson's Third Admission: Cardiogenic Shock and Treatment

172. CCC: The Hemodynamic Evaluation of Cardiogenic Shock with Dr. Nosheen Reza

Cardionerds: A Cardiology Podcast

Part 1: Introduction and Clinical Assessment

00:00Introduction to Hemodynamics of Shock and the Swan-Ganz Catheter

Introduction to Hemodynamics of Shock and the Swan-Ganz Catheter

04:46Lessons from the ESCAPE Trial and Clinical Assessment of Hemodynamics

Lessons from the ESCAPE Trial and Clinical Assessment of Hemodynamics

07:52Accuracy of Clinical Assessment and Indications/Contraindications for PA Catheter Use

Accuracy of Clinical Assessment and Indications/Contraindications for PA Catheter Use

Part 2: Patient Case - Initial Assessment

12:38Introduction to Patient Case: Mr. Gavin Swanson

Introduction to Patient Case: Mr. Gavin Swanson

15:16Initial Hemodynamic Assessment of Mr. Swanson

Initial Hemodynamic Assessment of Mr. Swanson

20:10Best Practices for Measuring Pressure Waveforms and Systematic Interpretation of Hemodynamics

Best Practices for Measuring Pressure Waveforms and Systematic Interpretation of Hemodynamics

24:29Cardiac Output Assessment Methods and Left Ventricular Function Metrics

Cardiac Output Assessment Methods and Left Ventricular Function Metrics

28:08Aortic Pulsatility Index (API) and Right Ventricular Function Assessment

Aortic Pulsatility Index (API) and Right Ventricular Function Assessment

Part 3: Patient Case - Subsequent Admissions and Shock

32:22Mr. Swanson's Second Admission: Septic Shock

Mr. Swanson's Second Admission: Septic Shock

35:28Mr. Swanson's Third Admission: Cardiogenic Shock and Treatment

Mr. Swanson's Third Admission: Cardiogenic Shock and Treatment