• J Intensive Care Med · Jul 2005

    Review

    Management of cardiogenic shock attributable to acute myocardial infarction in the reperfusion era.

    • Claire S Duvernoy and Eric R Bates.
    • Division of Cardiovascular Medicine and Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
    • J Intensive Care Med. 2005 Jul 1;20(4):188-98.

    AbstractCardiogenic shock is the leading cause of death among patients hospitalized with acute myocardial infarction. It is defined as tissue hypoperfusion resulting from ventricular pump failure in the presence of adequate intravascular volume. Rapid assessment and triage of patients presenting in cardiogenic shock followed by appropriate institution of supportive therapies including vasopressor and inotropic agents, mechanical ventilatory support, and intra-aortic balloon pump counterpulsation are critical for effective management of these patients. However, emergency percutaneous coronary intervention or coronary artery bypass graft surgery is required to decrease mortality rates. Novel approaches, including inhibition of nitric oxide synthase and new mechanical support devices, may further decrease mortality rates, which remain high despite reperfusion therapy.

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