We often see a large pulse pressure in distributive shock (sepsis) from a low SVR (vasodilation)
Not everything is sepsis, don't be fooled! π§
When seen with an acute heart failure presentation π«π« it may be acute aortic valve regurgitation
Endocarditis is a common cause
Not everything is sepsis, don't be fooled! π§
When seen with an acute heart failure presentation π«π« it may be acute aortic valve regurgitation
Endocarditis is a common cause
Diastolic back flow into the LV through an incompetent aortic valve = low diastolic BP & elevated pulse pressure
Regurgitation can lead to pulmonary edema (LVEDP β¬οΈ, Left atrial pressure β¬οΈ = pulmonary edema)
And poor forward cardiac output may cause hypoperfusion (Shock)
Regurgitation can lead to pulmonary edema (LVEDP β¬οΈ, Left atrial pressure β¬οΈ = pulmonary edema)
And poor forward cardiac output may cause hypoperfusion (Shock)
Listen for a diastolic murmur and dx w/ echo
It's difficult to manage severe AR medically
Temporize by β¬οΈ diastolic filling time by increasing HR, β¬οΈBP/afterload if elevated & diurese
Dobutamine an option in those with shock by β¬οΈHR & β¬οΈ afterload
Tx = Urgent Surgical AVR
It's difficult to manage severe AR medically
Temporize by β¬οΈ diastolic filling time by increasing HR, β¬οΈBP/afterload if elevated & diurese
Dobutamine an option in those with shock by β¬οΈHR & β¬οΈ afterload
Tx = Urgent Surgical AVR
If you see endocarditis often you will see this!
What tips do you have?
What tips do you have?
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