Ultrasound for Critical Care Physicians: Cardiogenic Shock-This Is Not a Drill

Ramakrishna Chaikalam, MD 

Shozab Ahmed, MD

Division of Pulmonary, Critical Care and Sleep

University of New Mexico

Albuquerque, NM

A 45-year-old woman with no significant past history developed gradual onset of shortness of breath and cough over 1 week. She presented to the emergency department. Her initial chest x-ray showed an enlarged heart and bilateral pulmonary edema. The patient became progressively hypotensive and hypoxic and was intubated. Transthoracic echocardiography is shown below (Figure 1).

Figure 1. Transthoracic echocardiogram in the para-sternal long axis view of the heart.

What intra-cardiac device in the left ventricle is pictured on the image? (Click on the correct answer to proceed to the next panel)

1. Amplatz closure device of atrial septal defect
2. Extracorporeal membrane oxygenator (ECMO) cannula
3. Impella device
4. Intra-aortic balloon pump
5. Pacemaker lead

Reference as: Chaikalam R, Ahmed S. Ultrasound for critical care physicians: cardiogenic shock-this is not a drill. Southwest J Pulm Crit Care. 2014;9(1):27-9. doi: http://dx.doi.org/10.13175/swjpcc091-14 PDF