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February 1971

Pulmonary Artery Pressure Monitoring In Cardiogenic Shock

Author Affiliations

Birmingham, Ala

From the Division of Cardiology, departments of medicine and surgery, University of Alabama Medical Center, Birmingham.

Arch Intern Med. 1971;127(2):304-306. doi:10.1001/archinte.1971.00310140132020

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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