Percutaneous transluminal coronary angioplasty in acute cardiogenic shock: an overview of the current strategy with a case illustration.
Cardiogenic shock from severe left ventricular dysfunction remains the most common cause of death in patients with acute myocardial infarction despite the advent of inotropic agents and intra-aortic balloon support. Lytic agents have not convincingly reduced mortality when administered in a shock scenario. Recently, observational studies have demonstrated survival benefit when mechanical revascularisation, particularly balloon angioplasty, is performed early in such patients. In this article, we report a case of an extensive anterior myocardial infarction with cardiogenic shock who underwent successful acute balloon angioplasty and prolonged intracoronary thrombolysis and use it to illustrate the current evolving interventional approach in the treatment of such a complex clinical syndrome.
Lau
K W
KW
Department of Cardiology, Singapore General Hospital.
Tan
A
A
Johan
A
A
D000208:Acute Disease; D015906:Angioplasty, Balloon, Coronary; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy*