Condition

Cardiac Index, (L/min)/m²

PCW, mmHg

Systolic bp, mmHg

Treatment

Uncomplicated

>2.5

≤18

>100

—

Hypovolemia

< 2.5

< 15

< 100

Successive boluses of normal saline

In setting of inferior wall MI, consider RV infarction (esp. if RA pressure >10)

Volume overload

>2.5

>20

>100

Diuretic (e.g., furosemide 10–20 mg IV)

Nitroglycerin, topical paste or IV (Table 126-1)

LV failure

< 2.5

>20

>100

Diuretic (e.g., furosemide 10–20 mg IV)

IV nitroglycerin (or if hypertensive, use IV nitroprusside)

Severe LV failure

< 2.5

>20

< 100

If bp ≥90: IV dobutamine ± IV nitroglycerin or sodium nitroprusside

If bp < 90: IV dopamine

If accompanied by pulmonary edema: attempt diuresis with IV furosemide; may be limited by hypotension

If new systolic murmur present, consider acute VSD or mitral regurgitation

Cardiogenic shock

< 2.2

>20

< 90 with oliguria and confusion

IV dopamine

Intraaortic balloon pump

Reperfusion by PCI or CABG may be life-saving