Multidisciplinary teams for cardiogenic shock

Cardiogenic shock (CS) is a state of end-organ hypoperfusion due to a primary cardiac problem associated with high mortality and morbidity in the contemporary era [1,2].More than 80% of all CS cases in the modern era are due to acute myocardial infarction (AMI) [1,2].Despite rapid advancements in the field of interventional cardiology and percutaneous coronary interventions (PCI), AMI-CS continues to be associated with high mortality in excess of 30-40% [3-5].However, despite shorter door-to-balloon times and greater use of coronary angiography and PCI in recent years, there appears to be minimal incremental mortality benefit in this population [1].AMI-CS follows a 'hemometabolic' cascade, wherein the initial hemodynamic Editorial insult subsequently results in metabolic derangement causing multi organ failure [1,6].Our group has previously shown that patients with AMI-CS have developed greater rates of non-cardiac organ failure highlighting the need for holistic management of these patients [1].In light of these considerations, there is a crucial need for developing paradigms for multidisciplinary care for AMI-CS patients (Figure 1) [5,7, 8].Patients with AMI-CS often have a dynamic pathophysiology and a rapidly evolving clinical picture as noted in our Figure 1.Care for such patients frequently involves anticipating patient trajectories, closely evaluating for complications, management of complications, and preventing/treating non-cardiac organ failure.