title: [Acute heart failure and cardiogenic shock: pathophysiology, clinical aspects and management strategies].
abstract: Irrespective of improved medical and interventional therapeutic options, mortality among patients with acute heart failure and cardiogenic shock has remained disappointingly high. Early diagnosis and rapid initiation of basic treatment measures to improve hemodynamics and metabolism are of vital importance until causal therapy, e. g. revascularization, is initiated. Due to the principal difficulty to set up larger clinical trials, in patients with cardiogenic shock empirical rather than firm evidence supports the various treatment and management strategies currently in use. Continuous hemodynamic monitoring to tailor fluid therapy, new drugs, and prognostic markers have been developed for the treatment and monitoring of cardiogenic shock, all of which await testing in larger-scale studies. Ongoing challenges remain the right ventricular pump failure or hemodynamically compromising arrhythmia which may be either cause or consequence of cardiogenic shock.
authors.affiliation: Medizinische Poliklinik, Universität Würzburg.
authors.forename: S
authors.initials: S
authors.lastname: Störk
authors.forename: C E
authors.initials: CE
authors.lastname: Angermann
authors.forename: G
authors.initials: G
authors.lastname: Ertl
mesh_terms: D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology; D017052:Hospital Mortality; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy