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Pulmonary Artery Pressure Monitoring In Cardiogenic Shock

C. McGavock Porter, MD; Robert B. Karp, MD; Richard O. Russell Jr., MD; Charles E. Rackley, MD
Arch Intern Med. 1971;127(2):304-306. doi:10.1001/archinte.1971.00310140132020.
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The management of patients with cardiogenic shock associated with acute myocardial infarction is attended by a high mortality. Recently, measurement of left ventricular filling pressure, either directly by left heart catheterization or indirectly by recording of pulmonary artery diastolic pressure, has been performed and advocated as a guide to therapy.1-3 This communication describes a patient in whom long-term continuous monitoring of pulmonary arterial pressure was useful in determining therapy after rupture of the interventricular septum following an acute myocardial infarction.

Patient Summary  A 67-year-old-male physician developed signs of acute left ventricular failure and a grade 4/6 apical holosystolic murmur four days after an acute myocardial infarction. Despite the administration of digoxin and furosemide, heart failure progressed over a ten-day period, and he was transferred to the University Hospital. Physical examination revealed a markedly ill, dyspneic white man with cool moist skin. Blood pressure was 90/60 mm Hg; pulse rate,


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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