CARDIOGENIC-SHOCK - THERAPY AND PREVENTION

Cardiogenic shock is defined as profound circulatory failure resulting in insufficient tissue perfusion to meet resting metabolic demands. I t occurs in approximately 7.5% of patients with acute myocardial infar ction. Treatment strategies include inotropic agents, use of intra-aor tic balloon counterpulsation, and revascularization. Current evidence supports the use of primary angioplasty. Surgery should be considered in patients with triple-vessel disease. If early catheterization is no t available, thrombolytic therapy should be given to eligible patients and transfer to an interventional facility should be considered. Effe ctive therapy for shock must also include a prevention strategy. This requires identification of patients at high risk for shock development and selection of patients who are candidates for aggressive intervent ion.