A Multidisciplinary Approach to Electrical Instability and Cardiogenic Shock in Acute Myocardial Infarction

Shuktika Nandkeolyar; Tahmeed Contractor; Rahul Bhardwaj; Ravi Mandapati; Antoine Sakr; Islam Abudayyeh; Anees Razzouk; Aditya Satish Bharadwaj

doi:10.1016/j.jaccas.2020.07.059

A Multidisciplinary Approach to Electrical Instability and Cardiogenic Shock in Acute Myocardial Infarction

JACC Case Rep. 2020 Nov 18;2(13):2053-2059. doi: 10.1016/j.jaccas.2020.07.059. eCollection 2020 Nov.

Authors

Shuktika Nandkeolyar¹, Tahmeed Contractor¹, Rahul Bhardwaj¹, Ravi Mandapati¹, Antoine Sakr¹, Islam Abudayyeh¹, Anees Razzouk², Aditya Satish Bharadwaj¹

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, California.
² Department of Cardiothoracic Surgery, Loma Linda University Medical Center, Loma Linda, California.

Abstract

New cardiogenic shock classifications allow prompt recognition and management of complications of acute coronary syndrome. A 59-year-old man presented after a delayed left anterior descending coronary artery ST-segment elevation myocardial infarction in Society of Cardiovascular Angiography and Interventions stage E cardiogenic shock and ventricular tachycardia storm. He underwent revascularization of the left anterior descending artery, percutaneous left ventricular assist device bridged to permanent assist device placement, epicardial and endocardial ventricular tachycardia ablation, and iatrogenic closure of an atrial septal defect. (Level of Difficulty: Beginner.).

Keywords: ASD closure; CPO, cardiac power output; CRT-D, cardiac resynchronization therapy defibrillator; LAD, left anterior descending (coronary artery); LV, left ventricular; LVAD, left ventricular assist device; PCI, percutaneous coronary intervention; RV, right ventricular; STEMI, ST-segment elevation myocardial infarction; TIMI, Thrombolysis In Myocardial Infarction; VT, ventricular tachycardia; cardiogenic shock; delayed STEMI presentation; mechanical assist devices; ventricular tachycardia storm.

Publication types

Case Reports