Mechanical versus pharmacologic support for cardiogenic shock.
Dynamic left ventricular outflow tract obstruction is a rare cause of cardiogenic shock after an acute myocardial infarction. A case is presented where inotropic support and an intra-aortic balloon pump aggravated the cardiac hemodynamics by this mechanism. The circulatory support provided by Impella 2.5 heart pump, in addition to discontinuation of inotropic support and intra-aortic balloon pump, allowed stabilization and successful percutaneous revascularization.
Dhar
Gaurav
G
Department of Medicine, The University of Chicago Medical Center, Chicago, Illinois 60637, USA.
Jolly
Neeraj
N
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D002316:Cardiotonic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015607:Stents; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*
D002316:Cardiotonic Agents