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#1
04-21-2011
 USMLE Forums Guru Steps History: 1+CK+CS Posts: 378 Threads: 161 Thanked 103 Times in 52 Posts Reputation: 117
Cardiac output (dyne/sec)

What is the mean of

Cardiac Output = 2000 dyne/sec normal (700 - 1200)??

this mean increased or decreased Cardiac Output
 The above post was thanked by: aktorque (04-25-2011)

#2
04-21-2011
 USMLE Forums Scout Steps History: Step 1 Only Posts: 63 Threads: 12 Thanked 148 Times in 44 Posts Reputation: 168

Dyn or Dyne means the force needed to move 1gm in one direction in one second.

In your example it obviously means increased cardiac output
 The above post was thanked by: aktorque (04-25-2011)
#3
04-21-2011
 USMLE Forums Guru Steps History: 1+CK+CS Posts: 378 Threads: 161 Thanked 103 Times in 52 Posts Reputation: 117

A 67-year-old Caucasian male is hospitalized in the intensive care unit (ICU) with an episode of prolonged hypotension and shortness of breath. His skin is cold and clammy. Intra-arterial blood pressure monitoring is established, and pulmonary artery catheterization is performed to control basic hemodynamic parameters. His blood pressure is 70/40 mmHg, and heart rate is 100/min. Cardiac output (CO) measured by thermodilution method is 2.3 L/min. Pulmonary capillary wedge pressure (PCWP) is estimated to be 22 mmHg. Systemic vascular resistance (SVR) calculated using data on mean arterial pressure, right atrial pressure and cardiac output is 2000 dynes*s/cm5 (N = 700 - 1200 dynes*s/cm5). Which of the following is the most likely underlying problem in this patient?

A ). Cardiogenic shock
B ). Volume depletion
C ). Septic shock
E ). Right ventricular infarction
F ). Pulmonary artery embolism
G ). Neurogenic shock
H ). Non-cardiogenic pulmonary edema

#4
04-21-2011
 USMLE Forums Guru Steps History: 1+CK+CS Posts: 378 Threads: 161 Thanked 103 Times in 52 Posts Reputation: 117

Quote:
 Originally Posted by Sarah-cali Dyn or Dyne means the force needed to move 1gm in one direction in one second. In your example it obviously means increased cardiac output

#5
04-21-2011
 USMLE Forums Addict Steps History: Step 1 Only Posts: 103 Threads: 3 Thanked 21 Times in 17 Posts Reputation: 31

Quote:
 Originally Posted by kemoo1985 A 67-year-old Caucasian male is hospitalized in the intensive care unit (ICU) with an episode of prolonged hypotension and shortness of breath. His skin is cold and clammy. Intra-arterial blood pressure monitoring is established, and pulmonary artery catheterization is performed to control basic hemodynamic parameters. His blood pressure is 70/40 mmHg, and heart rate is 100/min. Cardiac output (CO) measured by thermodilution method is 2.3 L/min. Pulmonary capillary wedge pressure (PCWP) is estimated to be 22 mmHg. Systemic vascular resistance (SVR) calculated using data on mean arterial pressure, right atrial pressure and cardiac output is 2000 dynes*s/cm5 (N = 700 - 1200 dynes*s/cm5). Which of the following is the most likely underlying problem in this patient? A ). Cardiogenic shock B ). Volume depletion C ). Septic shock D ). Volume overload E ). Right ventricular infarction F ). Pulmonary artery embolism G ). Neurogenic shock H ). Non-cardiogenic pulmonary edema
the SVR is increased not the CO....that should be hypovolemic shock i think because signs are of shock and it is obviously not cardiogenic as CO is normal.. the answer should be volume depletion
#6
04-21-2011
 USMLE Forums Guru Steps History: 1+CK+CS Posts: 472 Threads: 29 Thanked 224 Times in 135 Posts Reputation: 247

normal CO is about 5 lit/min not 2.3, the signs suggest cardiogenic shock
 The above post was thanked by: kemoo (04-21-2011), yarasara77 (08-07-2012)
#7
04-21-2011
 USMLE Forums Addict Steps History: Step 1 Only Posts: 103 Threads: 3 Thanked 21 Times in 17 Posts Reputation: 31

shucks you ARE right....it is 2.5/sq m of body and the body is 1.7 sqm for an average adult....Cardiac index is 2.6 not output...
so it should be cardiogenic shock..
#8
04-21-2011
 USMLE Forums Master Steps History: Step 1 Only Posts: 919 Threads: 134 Thanked 1,324 Times in 364 Posts Reputation: 1347

yes thank u... after reading it initially i was sure on volume depletion then i saw the lowered CO and tot no cardiogenic, then i saw increase SVR and i was back at volume depletion.

good discussion though. thx!
 The above post was thanked by: kemoo (04-21-2011)
#9
04-21-2011
 USMLE Forums Guru Steps History: 1+CK+CS Posts: 378 Threads: 161 Thanked 103 Times in 52 Posts Reputation: 117

right the answer is A - Cardiogenic shock
 The above post was thanked by: yarasara77 (08-07-2012)

 Tags Cardiology-, Step-2-Questions

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