Mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock

Rev Cardiovasc Med. 2022 Feb 21;23(2):71. doi: 10.31083/j.rcm2302071.

Abstract

Patients with acute myocardial infarction (MI) complicated by cardiogenic shock (CS) have poor prognosis. Over the last two decades, there has been some improvement in mortality rates associated with CS. Initial measures to stabilise patients should follow a shock protocol, including therapies such as volume expansion, inotropes/vasopressors, and early coronary revascularisation. The use of mechanical circulatory support (MCS) devices demonstrated better haemodynamic and metabolic profiles for patients with CS. However, these benefits have not been consistently translated into significant reductions in cardiovascular adverse events. This review aims to discuss emerging concepts related to CS including an update on its classification and pathophysiology. The focus is on recent evidence regarding the use of MCS and the timing of initiating in patients with CS.

Keywords: Cardiogenic shock; ECMO; IABP; Impella.

Publication types

  • Review

MeSH terms

  • Heart-Assist Devices* / adverse effects
  • Humans
  • Intra-Aortic Balloon Pumping
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / diagnosis
  • Myocardial Infarction* / therapy
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy
  • Treatment Outcome