Current concepts in the management of cardiogenic shock

Richard G TrohmanCardiology, Electrophysiology, Arrhythmia and Pacemaker Service, Department of Medicine, Rush University Medical Center, Chicago, IL, USAAbstract: Cardiogenic shock most commonly results from myocardial infarction and is associated with mortality rates ranging from 40% to 50%. Early revascularization improves mortality. Mechanical complications of myocardial infarction require surgical intervention. Medical, device and mechanical therapies may improve hemodynamics, but are not associated with improvement in short term survival. Massive pulmonary embolism may also result in cardiogenic shock. Prevention of fatal RV failure requires treatment that will result in rapid restoration of flow through the occluded pulmonary arteries. This review summarizes these and other clinical entities that may result in cardiogenic shock with an emphasis placed on a guideline-based approach to their management.Keywords: myocardial infarction, revascularization, mechanical complications, surgery, pulmonary embolis