학술논문

A Long-Forgotten Tale: The Management of Cardiogenic Shock in Acute Myocardial Infarction
Document Type
article
Source
Journal of Cardiovascular Emergencies, Vol 4, Iss 4, Pp 170-177 (2018)
Subject
cardiogenic shock
mechanical support devices
acute heart failure
acute myocardial infarction
Diseases of the circulatory (Cardiovascular) system
RC666-701
Language
English
ISSN
2457-5518
Abstract
Patients with acute myocardial infarction (AMI) complicated with cardiogenic shock (CS) present one of the highest mortality rates recorded in critical care. Mortality rate in this setting is reported around 45-50% even in the most experienced and well-equipped medical centers. The continuous development of ST-segment elevation acute myocardial infarction (STEMI) networks has led not only to a dramatic decrease in STEMI-related mortality, but also to an increase in the frequency of severely complicated cases who survive to be transferred to tertiary centers for life-saving treatments. The reduced effectiveness of vasoactive drugs on a severely altered hemodynamic status led to the development of new devices dedicated to advanced cardiac support. What’s more, efforts are being made to reduce time from first medical contact to initiation of mechanical support in this particular clinical context. This review aims to summarize the most recent advances in mechanical support devices, in the setting of CS-complicated AMI. At the same time, the review presents several modern concepts in the organization of complex CS centers. These specialized hubs could improve survival in this critical condition.