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. 2023 Jul-Dec;7(3-4):76-80.
doi: 10.1016/j.ihjccr.2023.07.002. Epub 2023 Jul 5.

Society of Cardiovascular Angiography and intervention Stage-B cardiogenic shock: An interventional-heart failure-critical care conundrum

Aryan Mehta  1 , Mridul Bansal  1 , Peter Matthew Belford  1 , Olivia N Gilbert  2 , David X Zhao  1 , Saraschandra Vallabhajosyula  3
Affiliations

Society of Cardiovascular Angiography and intervention Stage-B cardiogenic shock: An interventional-heart failure-critical care conundrum

Aryan Mehta et al. IHJ Cardiovasc Case Rep. 2023 Jul-Dec.

Abstract

The Society of Cardiovascular Angiography and Intervention (SCAI) classified cardiogenic shock (CS) into five stages ranging from A-E. There remains significant ambiguity regarding the assessment and management of SCAI Stage B. Given its nebulous nature that can rapidly escalate, prompt interventions are needed. Here, we describe the trajectory of cases that presented with SCAI Stage B CS.

Keywords: Cardiogenic shock; Mechanical circulatory support; Mixed shock; SCAI stage B.

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Conflict of interest statement

Declaration of competing interest None.

Figures

Fig. 1.
Fig. 1.
Clinical Case 1 Electrocardiogram (A), coronary angiogram (pre [B] and post[C] percutaneous coronary intervention), and echocardiogram (D) demonstrating anterior ST-segment elevation myocardial infarction with evidence of mid-left anterior descending artery thrombotic occlusion and severe mitral regurgitation without ischemic leaflet tethering.
Fig. 2.
Fig. 2.
Clinical Case 2 Electrocardiogram (A), echocardiogram (B) coronary angiogram (pre [C] and post[D] percutaneous coronary intervention along with the presence of left ventricular assist device [Impella]), and echocardiogram (E) demonstrating anterior ST-segment elevation myocardial infarction with evidence of proximal left anterior descending artery thrombotic occlusion and normal left ventricular systolic function.
Fig. 3.
Fig. 3.
Clinical Case 3 Electrocardiogram (A), coronary angiogram (pre [B] and post[C] percutaneous coronary intervention along with the presence of left ventricular assist device [Impella]), and echocardiogram (D) demonstrating anterior ST-segment elevation myocardial infarction with evidence of proximal left anterior descending artery thrombotic occlusion and decreased left ventricular systolic function.
Fig. 4.
Fig. 4.
Clinical Case 4 Electrocardiogram (A), coronary angiogram (pre [B] and post[C] percutaneous coronary intervention), and echocardiogram (D) demonstrating anterior ST-segment elevation myocardial infarction with evidence of proximal left anterior descending artery thrombotic occlusion, decreased left ventricular systolic function, and apical mural thrombosis. Repeat electrocardiogram (E) on day 3 demonstrating antero-lateral ST-segment-elevation. Repeat coronary angiography demonstrating sub-acute stent thrombosis of proximal left anterior descending artery stent (F) needing repeat balloon angioplasty (G) and aspiration thrombectomy demonstrating coronary thrombus (H). Subsequent stabilization of cardiogenic shock using TandemHeart ® percutaneous left ventricular assist device (I).
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References

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