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Related Concept Videos

Blood Pressure Imbalances and Circulatory Shock01:24

Blood Pressure Imbalances and Circulatory Shock

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Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
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Measurement of Blood Pressure01:17

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Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
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Cardiac Output I:Effect of Heart Rate on Cardiac Output01:19

Cardiac Output I:Effect of Heart Rate on Cardiac Output

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Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...
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Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

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Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
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Special considerations while measuring blood pressure01:28

Special considerations while measuring blood pressure

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When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
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Blood Pressure01:24

Blood Pressure

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The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
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Related Experiment Video

Updated: Jan 16, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Association Between Pressure-Adjusted Heart Rate and In-Hospital Mortality in Cardiogenic Shock.

Curtis R Ginder1, Jacob C Jentzer2, Siddharth M Patel1

  • 1Levine Cardiac Intensive Care Unit, TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.

JACC. Advances
|October 3, 2025
PubMed
Summary
This summary is machine-generated.

Higher pressure-adjusted heart rate (PAHR) in cardiogenic shock (CS) patients is linked to increased in-hospital mortality. This simple hemodynamic index offers valuable prognostic insight for CS patients.

Keywords:
cardiac intensive care unitcardiogenic shockinvasive hemodynamicspressure-adjusted heart raterisk stratification

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Hemodynamics

Background:

  • Elevated right atrial pressure (RAP) and low mean arterial pressure (MAP) correlate with higher mortality in cardiogenic shock (CS).
  • Pressure-adjusted heart rate (PAHR) integrates heart rate, RAP, and MAP, but its prognostic value in CS is unestablished.

Purpose of the Study:

  • To determine if PAHR values are associated with the risk of in-hospital mortality among patients experiencing CS.

Main Methods:

  • Utilized data from the Critical Care Cardiology Trials Network (CCCTN) registry (2018-2023).
  • Analyzed 1411 CS admissions with invasive hemodynamic assessment within 24 hours of ICU admission, excluding those on mechanical support.
  • Adjusted logistic regression models for age, sex, vasoactive-inotropic score, SCAI stage, and preceding cardiac arrest.

Main Results:

  • A stepwise increase in in-hospital mortality was observed with higher presenting PAHR values.
  • Higher PAHR was incrementally associated with increased in-hospital mortality (adjusted OR per 10 units: 1.35 [95% CI: 1.15-1.58]).
  • PAHR demonstrated stronger prognostic associations with mortality compared to its individual hemodynamic components.

Conclusions:

  • PAHR is a simple hemodynamic index derived from vital signs and central venous pressure.
  • PAHR is strongly associated with in-hospital mortality in patients with cardiogenic shock.