Hemodynamic Evaluation of Left Ventricular Function in Shock Complicating Myocardial Infarction

Twenty-two patients with shock complicating myocardial infarction were studied hemodynamically and, despite pharmacologic therapy and regulation of intravascular volume, 16 (73%) subsequently expired. Pulmonary artery end-diastolic pressure (PAEDP) or left ventricular end-diastolic pressure (LVEDP) was > 15 mm Hg in 18 of the 22 patients, and cardiac index (CI) was ≤2.3 liters/min/m 2 in 17 of 22 patients. Fourteen of the 18 patients with PAEDP or LVEDP > 15 mm Hg expired, while two of the four patients with a PAEDP or LVEDP 28 mm Hg and (2) PAEDP or LVEDP > 15 mm Hg in association with a CI < 2.3 liters/min/m 2 . Patients in cardiogenic shock with these hemodynamic alterations are presumably candidates for cardiocirculatory mechanical assisting devices and possibly for further surgical intervention.