Key result
Early revascularization improves cardiogenic shock survival, while medical and mechanical therapies only improve hemodynamics.
Why the study?
Cardiogenic shock has high mortality and multiple causes requiring different management strategies, but a comprehensive guideline-based summary is needed.
Early revascularization remains the cornerstone for improving mortality in cardiogenic shock, while other mechanical and medical therapies lack proven short-term survival benefits.
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.
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Richard G. Trohman (2014) conducted a review in Cardiogenic shock. Early revascularization improves mortality in cardiogenic shock, whereas medical, device, and mechanical therapies may improve hemodynamics but are not associated with short-term survival improvement.
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