Management of cardiogenic shock complicating myocardial infarction

Up to 10% of acute coronary syndromes are complicated by cardiogenic shock (CS) with contemporary mortality rates of 40–50%. The extent of ischemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis in this patient population. Individualized pat...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Intensive care medicine 2018-06, Vol.44 (6), p.760-773
Hauptverfasser: Mebazaa, Alexandre, Combes, Alain, van Diepen, Sean, Hollinger, Alexa, Katz, Jaon N., Landoni, Giovanni, Hajjar, Ludhmila Abrahao, Lassus, Johan, Lebreton, Guillaume, Montalescot, Gilles, Park, Jin Joo, Price, Susanna, Sionis, Alessandro, Yannopolos, Demetris, Harjola, Veli-Pekka, Levy, Bruno, Thiele, Holger
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Up to 10% of acute coronary syndromes are complicated by cardiogenic shock (CS) with contemporary mortality rates of 40–50%. The extent of ischemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis in this patient population. Individualized patient risk assessment plays an important role in determining appropriate revascularization, drug treatment with inotropes and vasopressors, mechanical circulatory support, intensive care support of other organ systems, hospital level of care triage, and allocation of clinical resources. This review will outline the underlying causes and diagnostic criteria, pathophysiology, and treatment of CS complicating acute coronary syndromes with a focus on (a) potential therapeutic issues from the perspective an interventional cardiologist, an emergency physician, and an intensive care physician, (b) the type of revascularization, and (c) new therapeutic advancements in pharmacologic and mechanical percutaneous circulatory support.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-018-5214-9