Clinical meaning
Shock: Hemodynamic Monitoring involves specific alterations in shock physiology. The pathophysiology of Shock encompasses changes in myocardial contractility, cardiac conduction, vascular resistance, endothelial function, or structural integrity depending on the primary mechanism involved. Key cellular processes include ion channel dysfunction, inflammatory mediator activation, oxidative stress, fibrotic remodeling, and neurohormonal dysregulation that drive the clinical manifestations of shock.
Diagnosis & workup
Diagnostics & workup: - Ambulatory blood pressure monitoring for white coat vs masked HTN - Lipid panel: total cholesterol, LDL, HDL, triglycerides - Echocardiography: EF, wall motion, valvular function, chamber dimensions - CBC with differential (anemia worsens cardiac ischemia) - TEE for valvular vegetation, intracardiac thrombus, PFO assessment - CT angiography of chest for aortic or pulmonary vascular pathology - Cardiac MRI for tissue characterization (edema, fibrosis, infiltration)
Risk factors: - Hypercoagulable states (Factor V Leiden, antiphospholipid) - Family history of premature CVD (<55 males, <65 females) - Age >65 with cardiovascular degeneration - Dyslipidemia (LDL >130 despite lifestyle modification) - Peripheral artery disease (ABI <0.9) - Obesity (BMI >30) with metabolic syndrome - Chronic kidney disease (eGFR <60 mL/min)