Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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).
See this image and copyright information in PMC

References

    1. Baran DA, Grines CL, Bailey S, et al. SCAI clinical expert consensus statement on the classification of cardiogenic shock: this document was endorsed by the American college of cardiology (ACC), the American heart association (AHA), the society of critical care medicine (SCCM), and the society of thoracic surgeons (STS) in april 2019. Cathet Cardiovasc Interv. Jul 1 2019;94(1):29–37. 10.1002/ccd.28329. - DOI - PubMed
    1. Jentzer JC, Burstein B, Van Diepen S, et al. Defining shock and preshock for mortality risk stratification in cardiac intensive care unit patients. Circulation: Heart Fail. 2021/01/01 2021;14(1), e007678. 10.1161/CIRCHEARTFAILURE.120.007678. - DOI - PubMed
    1. Kapur NK, Kanwar M, Sinha SS, et al. Criteria for defining stages of cardiogenic shock severity. J Am Coll Cardiol. Jul 19 2022;80(3):185–198. 10.1016/j.jacc.2022.04.049. - DOI - PubMed
    1. Urina Jassir D, Chaanine AH, Desai S, Rajapreyar I, Le Jemtel TH. Therapeutic dilemmas in mixed septic-cardiogenic shock. Am J Med. Jan 2023;136(1):27–32. 10.1016/j.amjmed.2022.09.022. - DOI - PubMed
    1. Ahmed AM, Tabi M, Wiley BM, et al. Outcomes associated with cardiac arrest in patients in the cardiac intensive care unit with cardiogenic shock. Am J Cardiol. Apr 15 2022;169:1–9. 10.1016/j.amjcard.2021.12.041. - DOI - PubMed

LinkOut - more resources