CARDIOGENIC SHOCK IN A PATIENT WITH LONG-TERM CORONARY ARTERY DISEASE (Atena Editora)

Abstract

Coronary artery disease, in developed countries, is a major cause of sudden death among men and women, accounting for about one third of all deaths. It occurs in 2% to 9% of people aged 20 years or older. The mortality rate tends to increase proportionally with age, being higher for men than for women. After the age of 55, the mortality rate among men decreases, and that of women increases progressively. In this literature review, we associate the clinical picture of a patient in cardiogenic shock due to coronary artery disease and its complications. We explore the management of symptom progression in the cardiologic emergency. The central development of the article was built based on the case report published in the book: Case Files Cardiology, by the publisher: McGraw-Hill Medical Publishing, case 4, page 60, edition 1. In the case in question, a patient was identified, 55-year-old male with a long history of coronary artery disease, admitted to the ICU with hypotension, followed by 24 hours with intermittent chest pain. An intravenous drug solution of nitroglycerin was administered to treat heart failure, leaving him free of chest pain. On the second day of hospitalization, the patient developed angina pectoris, dyspnea, and altered mental status. Data collection showed acute decompensation in his general condition. Cardiogenic shock was observed, due to hypotension, hypoperfusion, lowered mental status, and low oxygenation of the extremities. On physical examination, B3 heart sound was evident. Based on the clinical picture of this patient, we can observe the worsening of morbidity, through the description of the constant hemodynamic evaluation to detect the observed heart failure. We demonstrate the undeniable thorough and accurate assessment of patients with heart disease, in physical and laboratory examinations, in patients in cardiological emergencies.