[Cardiogenic shock: pathophysiology, clinics, therapeutical options and perspectives].
Documented mortality from myocardial infarction (MI) has significantly decreased from around 30% in the 1960s to 6-7% currently, following the introduction of intensive care treatment, thrombolysis, effective antithrombotic therapy and coronary angioplasty. However, the approximate mortality of 70-80% of patients with cardiogenic shock following acute MI has hardly improved despite the introduction of modern treatment strategies. The major cause of in-hospital MI mortality remains myocardial failure with consecutive cardiogenic shock and multi-organ failure. Prompt coronary revascularisation by "facilitated" or "adjunctive" percutaneous coronary intervention (PCI), is currently considered the best method to reduce the high mortality in these patients. Facilitated PCI includes administration of glycoproteine receptor antagonists, mechanical circulation support strategies, such as, intraaortic balloon counterpulsation and potentially prehospital thrombolysis.
Universitätsklinik und Poliklinik für Innere Medizin III, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale. roland.prondzinsky@medizin.uni-halle.de
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Werdan
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Buerke
D015906:Angioplasty, Balloon, Coronary; D002303:Cardiac Output, Low / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D002423:Cause of Death; D001026:Coronary Artery Bypass; D003422:Critical Care / Q000379:methods; D006439:Hemodynamics / Q000502:physiology; D017052:Hospital Mortality; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D009102:Multiple Organ Failure / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*