INTERVENTIONAL MANAGEMENT OF CARDIOGENIC-SHOCK

Management of the patient with cardiogenic shock requires rapid confir mation of the diagnosis and exclusion of potentially correctable condi tions. Early echocardiography is helpful to exclude mechanical causes of shock, such as unsuspected severe mitral insufficiency. Thrombolyti c therapy may help prevent shock, but its role in established shock is not clear. Intra-aortic balloon counter-pulsation may be of value, pa rticularly when used in conjunction with reperfusion therapy. Angiogra phy can be performed at relatively low risk in shuck patients. A windo w of opportunity is often available where revascularization may be of benefit.