title: Acute myocardial infarction and cardiogenic shock: pharmacologic and mechanical hemodynamic support pathways.
abstract: Cardiogenic shock (CS) is still the predominant cause of in-hospital death in patients with acute myocardial infarction, although mortality has been reduced in recent years. Early percutaneous coronary intervention and coronary artery bypass grafting are causal therapies implemented in CS, supported by catecholamines, fluids, intra-aortic balloon pumping, and also active percutaneous assist devices. There is only limited evidence from randomized studies of any of these treatments in CS, except for early revascularization and the relative ineffectiveness of intra-aortic balloon pumping. This review will present treatment pathways of CS complicating acute myocardial infarction, with a major focus on revascularization, intensive care unit treatment, and mechanical support devices.
authors.affiliation: University Heart Center Luebeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Luebeck, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Graf
authors.forename: Steffen
authors.initials: S
authors.lastname: Desch
authors.forename: Ingo
authors.initials: I
authors.lastname: Eitel
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D011474:Prosthesis Design; D020127:Recovery of Function; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D002317:Cardiovascular Agents