Key result
Serial hemodynamic monitoring unmasks occult RV failure requiring right-sided mechanical support during LV unloading.
Case Report (n=1)
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Case report reveals worsening hemodynamics in cardiogenic shock, highlighting the need for continuous monitoring.
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.
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Lemor et al. (2021) conducted a case report in myocardial infarction and cardiogenic shock (n=1). Serial hemodynamic monitoring was evaluated. Serial hemodynamic assessments in a cardiogenic shock patient on left ventricular support unmasked worsening hemodynamics secondary to right ventricular failure, requiring right-sided support.
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