Shock in acute myocardial infarction: the Cape Horn for trials?
Despite therapeutic improvements, cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction (AMI). In addition to percutaneous coronary intervention, inotropes, fluids, adjunctive medication, intra-aortic balloon counterpulsation, and also assist devices are widely used for treatment. However, currently, there is only limited evidence for any of the above treatments. This review will therefore outline the underlying causes, pathophysiology, and treatment of CS complicating AMI with major focus on interventional techniques and advancement of new therapeutical arsenals, both pharmacological and mechanical.
Thiele
Holger
H
Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Strümpellstrasse 39, Leipzig, Germany. thielh@medizin.uni-leipzig.de
Allam
Bachir
B
Chatellier
Gilles
G
Schuler
Gerhard
G
Lafont
Antoine
A
D002316:Cardiotonic Agents / Q000627:therapeutic use; D003327:Coronary Disease / Q000150:complications / Q000628:therapy; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005440:Fluid Therapy / Q000379:methods; D006353:Heart-Assist Devices; D006801:Humans; D053208:Kaplan-Meier Estimate; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D009204:Myocardial Revascularization; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors; D016032:Randomized Controlled Trials as Topic; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome
D002316:Cardiotonic Agents; D005343:Fibrinolytic Agents; D019001:Nitric Oxide Synthase