Key result
Lowering atrial pressures by venesection fails to improve cardiac performance in AMI with cardiogenic shock.
Why the study?
Does altering atrial pressure via venesection or isoproterenol affect cardiac performance in patients with acute myocardial infarction complicated by cardiogenic shock?
Observational (n=6)
Does altering atrial pressure via venesection or isoproterenol affect cardiac performance in patients with acute myocardial infarction complicated by cardiogenic shock?
In patients with cardiogenic shock complicating acute myocardial infarction, lowering atrial pressures via venesection produced little change in already depressed cardiac performance indices.
Answers are grounded in this paper and cite their sources.
Little hemodynamic gain follows venesection in AMI cardiogenic shock; hypothesis-generating and leaves open optimal preload strategies pending larger studies.
Performance curves for both sides of the heart were derived in six patients with acute myocardial infarction complicated by cardiogenic shock. Stroke index and right and left ventricular stroke work index were related to mean atrial pressures which were lowered by venesection. Values for cardiac index, stroke index, and stroke work index were all low, and little change occurred with alterations in atrial pressures. The relationship of right and left atrial pressures to the genesis of pulmonary edema is discussed, and the effects of isoproterenol (isoprenaline) are described.
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Bradley et al. (1970) conducted an observational in Acute myocardial infarction complicated by cardiogenic shock (n=6). Lowering of mean atrial pressures via venesection was evaluated on Cardiac performance (cardiac index, stroke index, and stroke work index). Lowering mean atrial pressures by venesection produced little change in the already low values for cardiac index, stroke index, and stroke work index in patients with AMI and cardiogenic shock.
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