Cardiogenic shock: therapy and prevention.
Cardiogenic shock is defined as profound circulatory failure resulting in insufficient tissue perfusion to meet resting metabolic demands. It occurs in approximately 7.5% of patients with acute myocardial infarction. Treatment strategies include inotropic agents, use of intra-aortic balloon counterpulsation, and revascularization. Current evidence supports the use of primary angioplasty. Surgery should be considered in patients with triple-vessel disease. If early catheterization is not available, thrombolytic therapy should be given to eligible patients and transfer to an interventional facility should be considered. Effective therapy for shock must also include a prevention strategy. This requires identification of patients at high risk for shock development and selection of patients who are candidates for aggressive intervention.
Barry
W L
WL
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Sarembock
I J
IJ
D002316:Cardiotonic Agents / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods; D008875:Middle Aged; D009200:Myocardial Contraction; D009204:Myocardial Revascularization / Q000379:methods; D012770:Shock, Cardiogenic / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000628:therapy
D002316:Cardiotonic Agents; D005343:Fibrinolytic Agents