Cardiogenic Shock in the Setting of Acute Myocardial Infarction

Abstract

Cardiogenic shock in the setting of acute myocardial infarction remains a major cause of morbidity and mortality. In fact, acute myocardial infarction accounts for 81% of patients in cardiogenic shock. Despite advances in pharmacologic and device-based approaches to support patients with cardiogenic shock, no significant improvement in mortality has been observed over the past 20 years, although multiple registries are providing new insight into this complex syndrome. Key elements for optimal treatment include integration of hemodynamic and metabolic data for diagnosis and risk stratification, early evaluation and appropriate initiation of acute mechanical circulatory support devices, and an organized algorithmic approach to decision making.

Keywords: acute mechanical circulatory support; acute myocardial infarction; cardiogenic shock; early revascularization; risk assessment; shock classification.

Figure 1.

Cardiogenic Shock Algorithm developed by the INOVA Heart and Vascular Institute. Republished with permission of Elsevier Science & Technology Journals, from Standardized Team-Based Care for Cardiogenic Shock, Tehrani et al., 73(13), 2019.