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Case Reports in Cardiology - Volume 2017 2017, Article ID 8407530, 4 pages - https:-doi.org-10.1155-2017-8407530

Case Report

Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

Division of Cardiology, University of Maryland School of Medicine, Baltimore, MD, USA

Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

Correspondence should be addressed to Praveen George

Received 26 October 2016; Revised 15 January 2017; Accepted 18 January 2017; Published 5 February 2017

Academic Editor: Expedito E. Ribeiro

Copyright © 2017 Praveen George et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cardiac dysfunction is a common complication of sepsis in individuals with preexisting coronary disease and portends a poor prognosis when progressing to ischemic cardiogenic shock. In this setting, maximal medical therapy in isolation is often inadequate to maintain cardiac output for patients who are poor candidates for immediate revascularization. Furthermore, the use of vasopressors and inotropes increases myocardial demand and may lead to further injury. Percutaneous ventricular assist devices provide a viable option for management of severe shock with multiorgan failure. The Impella is one of several novel mechanical support systems that can effectively augment cardiac output while reducing myocardial demand and serve as a bridge to recovery from severe hemodynamic compromise. This case report describes the successful utilization of the Impella 2.5 in a patient with baseline profound anemia and coronary artery disease CAD presenting in combined distributive and cardiogenic shock associated with a type 2 myocardial infarction complicating sepsis.





Autor: Praveen George, Mukta C. Srivastava, Jonathan Ludmir, Robert M. Reed, Semhar Z. Tewelde, Anuj Gupta, and Michael T. McCurdy

Fuente: https://www.hindawi.com/



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