Cardiogenic shock

Summary

Cardiogenic shock represents a critical, potentially intricate, and variably hemodynamic condition characterized by inadequate perfusion of vital organs, often leading to multisystem organ dysfunction.

Its occurrence in the setting of acute myocardial infarction (AMI) is frequent and carries a significant risk of mortality. The presence of ischemic myocardial tissue significantly influences the initial, inpatient, and post-discharge management as well as the prognosis of individuals experiencing cardiogenic shock. Thorough risk evaluation, guided by clinical parameters, plays a pivotal role in determining the necessity for aggressive therapeutic interventions, appropriate triage within various levels of hospital care, and the allocation of medical resources.

This chapter aims to elucidate the aetiology, diagnostic benchmarks, pathophysiology, and management of cardiogenic shock complicating AMI, encompassing mechanical complications and right ventricular failure-induced shock.

Emphasis will be placed on potential therapeutic avenues from both interventional cardiology and intensive care standpoints, including advancements in circulatory and pharmacological support. Given the inherent difficulties in conducting randomized trials within the cardiogenic shock population, we will also delve into the specific challenges encountered in past clinical investigations and their implications for future research endeavours in this domain.

Introduction

Cardiogenic shock represents a critical and complex hemodynamic condition marked by insufficient perfusion of...