title: A stepwise progression in the treatment of cardiogenic shock.
abstract: Cardiogenic shock remains a deadly complication of acute myocardial infarction (MI). Early revascularization, inotropic support, and intraaortic balloon counterpulsation are the mainstays of treatment, but these are not always sufficient. New mechanical approaches, both percutaneous and surgical, are available in this high-risk population. We present a case of a young woman with a massive anterior wall MI and subsequent cardiogenic shock who was treated with advanced mechanical circulatory support. This case serves as an illustration of the stepwise escalation of mechanical support that can be applied in a patient with an acute MI complicated by refractory cardiogenic shock. We also review the literature with regard to the use of percutaneous left ventricular assist devices in the setting of cardiogenic shock.
authors.affiliation: Department of Medicine, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York, USA.
authors.forename: Ari
authors.initials: A
authors.lastname: Pollack
authors.forename: Nir
authors.initials: N
authors.lastname: Uriel
authors.forename: Isaac
authors.initials: I
authors.lastname: George
authors.forename: Susheel
authors.initials: S
authors.lastname: Kodali
authors.forename: Hiroo
authors.initials: H
authors.lastname: Takayama
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Naka
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jorde
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006353:Heart-Assist Devices; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D012770:Shock, Cardiogenic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult