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Cardiogenic shock complicates approximately 5-10 % of all MI events and remains the most common cause of death among MI cases. Over the past few decades, the mortality rate associated with cardiogenic shock has decreased with the introduction of early revascularisation, although there are limited data for patients with triple-vessel disease and left main stem disease. In more recent years, there have been a number of advances in the mechanical circulatory support devices that can help improve the haemodynamics of patients in cardiogenic shock. Despite these advances, together with progress in the use of inotropes and vasopressors, cardiogenic shock remains associated with high morbidity and mortality rates. This review will outline the management of cardiogenic shock complicating acute MI with a smajor focus on revascularisation techniques and the use of mechanical circulatory support devices.
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http://dx.doi.org/10.15420/icr.2016.11.1.39 | DOI Listing |
South Afr J Crit Care
May 2025
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background: Shock, characterised by circulatory hypoperfusion and cellular hypoxia, represents a critical medical condition requiring immediate attention. Despite its significance, there are limited data on shock incidence and outcomes, particularly within the context of Thailand.
Objectives: This retrospective observational study aimed to investigate the incidence, management and outcomes of shock patients admitted to the internal medicine department of Siriraj Hospital, a referral university hospital in Bangkok, Thailand.
Eur Heart J Open
September 2025
Calderdale and Huddersfield NHS Foundation Trust, Acre St, Lindley, Huddersfield HD3 3EA, UK.
Aims: Cardiogenic shock remains a significant cause of mortality despite multiple advancements in medical interventions. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides crucial circulatory support but also increases left ventricular (LV) after-load, potentially worsening outcomes. Effective LV unloading strategies can enhance patient survival during VA-ECMO treatment.
View Article and Find Full Text PDFRev Cardiovasc Med
August 2025
Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy.
Harlequin syndrome, also known as differential hypoxia (DH) or North-South syndrome, is a serious complication of femoro-femoral venoarterial extracorporeal membrane oxygenation (V-A ECMO). Moreover, Harlequin syndrome is caused by competing flows between the retrograde oxygenated ECMO output and the anterograde ejection of poorly oxygenated blood from the native heart. In the setting of impaired pulmonary gas exchange, the addition of an Impella device (ECPELLA configuration), although beneficial for ventricular unloading and hemodynamic support, may further exacerbate this competition and precipitate DH.
View Article and Find Full Text PDFClin Res Cardiol
September 2025
Department of (Interventional) Cardiology, Thoraxcenter, Erasmus University Medical Center, Room Rg-628, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Background: Fractional flow reserve (FFR) for non-culprit lesions (NCLs) in patients with ST-elevation myocardial infarction (STEMI) can be influenced by temporary changes in microvascular resistance. Angiography-derived vessel fractional flow reserve (vFFR) has been tested as a less-invasive alternative.
Aims: The FAST STEMI II study aimed to assess the diagnostic performance of acute-setting vFFR vs.
ESC Heart Fail
September 2025
Department of Cardiac-, Thoracic-, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Aims: Non-pharmacological therapies for acute decompensated heart failure (HF) and cardiogenic shock have evolved considerably in recent decades. Short-term mechanical circulatory support (MCS) devices can be used as circulatory backup. While nearly all available devices use continuous flow, evidence indicates that pulsatile flow can be more effective.
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