Critical care clinics
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Cardiogenic shock is the primary cause of death among patients hospitalized with acute myocardial infarction. It is defined as tissue hypoperfusion resulting from ventricular pump failure in the presence of adequate intravascular volume. ⋯ Whereas newer support devices can provide better hemodynamic augmentation, their impact on mortality is limited. Novel therapies are needed to further decrease mortality rates, which remain high despite reperfusion therapy.
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A wide spectrum of acute cardiovascular disorders is seen in patients who are hospitalized in a critical care setting. Imaging plays a central role in the diagnosis and management of these conditions. ⋯ More recently, multidetector row CT (MDCT) and MRI are being used increasingly for evaluation of coronary artery disease, cardiac structure and function, coronary artery anomalies, cardiac masses, pericardial disease, valvular disease, postoperative cardiovascular abnormalities, venous thromboembolism and acute aortic syndromes, often with other ancillary findings that can provide important clinical information. The three most common life-threatening cardiovascular processes in which advanced imaging plays a role, particularly CT, are discussed, including pulmonary embolism, aortic dissection, and coronary artery disease.
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Acute aortic dissection is an uncommon but potentially catastrophic illness with high mortality. Significant advances in the understanding, diagnosis, and management have been made since the first reported case of aortic dissection 3 centuries ago. This comprehensive review discusses the pathophysiology, classification, clinical manifestations, early diagnosis, and management of this important cardiovascular emergency.