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Echocardiography's Role in Cardiogenic Shock After Acute Myocardial Infarction

Department of Diagnostic Ultrasound, Loma Linda University Medical center, Loma Linda, California.

Kenneth R. Jutzy, MD

Division of Cardiology, Loma Linda University Medical center, Loma Linda, California.

Marie de Lange, BS, RT, RDMS, RDCS

Department of Diagnostic Ultrasound, Loma Linda University Medical center, Loma Linda, California.

Cardiogenic shock is an emergent condition that requires immediate diagnosis. Assessment and evaluation of potential complications that often accompany shock must also be made. These complications may be seen individually or in concert. Echocardiography has emerged in the last two decades as the single most important procedure in this effort. The authors reviewed four cases of cardiogenic shock after acute myocardial infarction: two with ventricular septal rupture, one with papillary muscle rupture, and one with severe global left ventricular dysfunction. Each patient was evaluated emergently with echocardiography. Results were compared with electrocardiography, arteriography, right heart catheterization studies, and surgical reports.

Key Words: acute myocardial infarct • acute severe mitral regurgitation • cardiogenic shock • echocardiography • flail leaflet • hypotension • ventricular septal rupture

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