Cardiogenic Shock

Major advances in the management of congestive heart failure1 and acute myocardial infarction2 have ushered in a new era of optimism about the prognosis of patients with these disorders. Cardiac failure with cardiogenic shock continues to be a frustrating clinical problem, however, because of persistent mortality rates of 30 to 90 percent and substantial morbidity among hospitalized patients3,4. The management of this condition requires a rapid, well-organized approach. Avoiding futile intervention that is unlikely to prolong life or give patients a reasonable chance of functional recovery is also increasingly important in this era of limited resources and public . . .