2025 HFSA Contemporary Issues in Heart Failure - OnDemand-Advanced Hemodyamics in Cardiogenic Shock

Video Transcription

Video Summary

Dr. Manpreet Kanwar, a heart failure cardiologist, discusses advanced hemodynamics in managing cardiogenic shock. Using a clinical case, she illustrates how to assess shock severity via pressure-volume loops and emphasizes tailoring therapy based on individual hemodynamic needs rather than a one-size-fits-all approach. Different mechanical circulatory support (MCS) devices, like intra-aortic balloon pumps, Impella, and VA ECMO, have distinctive hemodynamic effects, necessitating precise matching to patient requirements for optimal outcomes. She highlights complications such as increased afterload with VA ECMO causing pulmonary edema that may require adjunct therapies. Advanced hemodynamic parameters such as Cardiac Power Output (CPO), Aortic Pulsatility Index (API), Pulmonary Artery Pulsatility Index (PAPI), and a composite Myocardial Performance Score (MPS) help risk stratify patients and predict prognosis, guiding timely and appropriate MCS use. Understanding and applying these metrics can distinguish recoverable states from irreversible shock, improving patient management in cardiogenic shock.

Keywords

cardiogenic shock

hemodynamics

mechanical circulatory support

pressure-volume loops

cardiac power output

pulmonary artery pulsatility index