[Intra-aortic balloon counterpulsation as percutaneous therapy option in cardiogenic shock].
Six months after sustaining a posterior wall myocardial infarction a 40-year-old man had a further infarction in the anterior wall region. After thrombolysis treatment with recombinant tissue plasminogen activator the patient was at first symptom-free and haemodynamically stable, but 48 hours later another anterior wall re-infarction occurred with cardiogenic shock. Despite infusions of catecholamines at highest dosage and successful coronary angioplasty the circulation became critically unstable and percutaneously introduced intraaortic balloon counterpulsation (IABCP) was commenced. As the haemodynamics improved catecholamine dosage was markedly reduced and then discontinued over the subsequent 24-48 hours and inspiratory oxygen concentration of the ventilated patient was decreased from 100% to 40%. After a total of 5 days the IABCP catheter was removed without complication. The cardiac pump action showed further improvement in the following days. 6 months later the patient's condition was stable in grade II-III (New York Heart Association classification) heart failure. This case illustrates the place of IABPC as a highly effective treatment option in myocardial infarction with cardiogenic shock, especially when combined with interventional revascularisation procedures.
Bauriedel
G
G
Medizinische Klinik I, Klinikum Grosshadern, Universität München.
Schwaiblmair
M
M
Kreuzer
E
E
Werdan
K
K
D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D002395:Catecholamines / Q000627:therapeutic use; D017023:Coronary Angiography; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012008:Recurrence; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage
D002395:Catecholamines; D010959:Tissue Plasminogen Activator
Intraaortale Ballon-Gegenpulsation als perkutane Therapieoption bei kardiogenem Schock.