Cardiogenic Shock and Its Treatment

Year 1968, Volume: 21 Issue: 3, 957 - 970, 30.09.1968

Gürler İliçin

https://izlik.org/JA37JP87ZH

Abstract

Clinical cardiogenic shock usually develops as a result of acute myocardial infarction, myocarditis, pulmonary emboly, paroxixmal tachycardias, pericardial tamponade, and heart blocks. it can also be observed in terminal period of the congestive heart failure. The basic cause of the fall of blood pressure, is primaly due to the 'inhibition of myocardial contractility. The cardiac index and the cardiac output are usually inhibited in the experimental and clinical shocks.
The peripheral resistance does not necessarily increase in every cases with falling blood pressure, such as in the adrenergic inhibition of a reflex mechanism which is originated from the damaged myocardial area.
Generally, the vasoconstrictor agents are used as a common treatment of the cardiogenic shock. tn addition of these beta adrenergic stimulating agents, alfa adrenergic blocking agents, on the other hand for the treatment of cardiac arrhytmias; beta adrenergic blocking agents have also been used. However using this scheme of treatment, the mortality is about % 60. Also it has been reported that counter-pulsation, by-pass of the left ventricule and venous-aortical shunt are in trial on the animals,

Keywords

cardiogenic shock , heart pulse , cardiology

Supporting Institution

ANKARA ÜNİVERİSTESİ TIP FAKÜLTESİ

KARDİYOJENİK ŞOK VE TEDAVİSİ

https://izlik.org/JA37JP87ZH

Abstract

Klinikte kardiyojenik şok sıklıkla akut myokard infarktüsünden sonra, daha az oranda da, çeşitli sebeplere bağlı myokarditis, kalb tamponadı, pulmoner emboli, uzun süren paroksismal takikar diler, ve blokla müterafık kalb dakika atım sayısının ve atım volü« münün ileri derecede azalmasından meydana gelir. Konjestif kalb yetmezliğinin terminal devrelerinde de şok tablosu teessüs edebilir.
Akut myokard infarktüsünden sonra kalb kontraktilitesinin ileri derecede azalması, kan basıncı düşmesinden ön plânda sorumludur. Deneysel ve klinik kardiyojenik şok vak'alarda kalb atım
volümü, kardiyak index düşük seyretmektedir. Her vak'ada, kan basıncı düşmesi ile beraber vasküler rezistansln artmadlžl; bam hallerde, leze kalb sahasından kalkan reflekslerle adrenerjik sistern aktivitesinin inhibe edildiği bildirilmistir.
Tedavide, hâ.len vasokonstriktörler ön plânda kullanılmaktadırlar. Bunun yanl slra, beta reseptörleri stimüle eden ilâçlar, alfa adrencrjik bloke ediciler, aritmilerin düzeltilebilmesi bakımdan, beta adrenerjik bloke ediciler denenmislerdir. Bütün tedavi imkânlamna rağmen, halen mortalite % 60 civarındadır. Bu bakımdan, lâbaratuvarlarda, sol ventrikül by pass'l, counter-pulsation, kalp venlerden aortaya pompalanması, yöntemleri denenmektedirler.

Keywords

kardiyojenik şok , kalp atımı , kardiyoloji

Supporting Institution

ANKARA ÜNİVERİSTESİ TIP FAKÜLTESİ

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