PATHOPHYSIOLOGY, INVESTIGATIONS, AND TREATMENT IN PATIENTS WITH CARDIOGENIC SHOCK: A REVIEW
OMAR ELSAKA *
Department of Cardiology, Mansoura University, Faculty of Medicine, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.
MONEER AYMAN NOURELDEAN
Department of Cardiology, Mansoura University, Faculty of Medicine, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.
Mohamed Adel GAMIL
Department of Cardiology, Mansoura University, Faculty of Medicine, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.
MOSTAFA TAREK GHAZALI
Department of Cardiology, Mansoura University, Faculty of Medicine, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.
ASHRAF HAMADA ABD AL-RAZIK
Department of Cardiology, Mansoura University, Faculty of Medicine, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.
DALIA HISHAM
Department of Cardiology, Mansoura University, Faculty of Medicine, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Cardiogenic shock is a type of heart failure characterized by decreased cardiac output, which causes end-organ hypoperfusion and tissue hypoxia. This exercise discusses the diagnosis and treatment of cardiogenic shock, as well as the role of the interprofessional team in enhancing patient care.
Conclusion: The purpose of this review article is to describe the etiology of cardiogenic shock, describe the history and physical examination of patients with cardiogenic shock, review the management of patients with cardiogenic shock, and explain the importance of collaboration and communication among the interprofessional team in improving the delivery of care for patients with cardiogenic shock.
Keywords: Cardiogenic shock, dobutamine, echocardiography, hypoperfusion, inotropic medications, intra-aortic balloon pump counterpulsation, percutaneous coronary intervention, vasopressor
How to Cite
Downloads
References
Feldman D, Pamboukian SV, Teuteberg JJ, et al. The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support: executive summary. J Heart Lung Transplant. 2013;32 (2):157-87.
Roffi M, Patrono C, Collet JP, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(3):267-315.
Alonso DR, Scheidt S, Post M, Killip T. Pathophysiology of cardiogenic shock. Quantification of myocardial necrosis, clinical, pathologic and electrocardiographic correlations. Circulation. 1973;48(3):588-96.
Al-Reesi A, Al-Zadjali N, Perry J, et al. Do beta-blockers reduce short-term mortality following acute myocardial infarction? A systematic review and meta-analysis. CJEM. 2008;10(3):215-23.
Amsterdam EA, Wenger NK, Brindis RG, et al, for the ACC, AHA Task Force on Practice Guidelines, et al. AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64 (24):e139-228.
Anderson ML, Peterson ED, Peng SA, et al. Differences in the profile, treatment, and prognosis of patients with cardiogenic shock by myocardial infarction classification: A report from NCDR. Circ Cardiovasc Qual Outcomes. 2013;6(6):708-15.
Antoniucci D, Valenti R, Migliorini A, Moschi G, Trapani M, Buonamici P, et al. Relation of time to treatment and mortality in patients with acute myocardial infarction undergoing primary coronary angioplasty. Am J Cardiol. 2002;89(11):1248-52.
Babaev A, Frederick PD, Pasta DJ, Every N, Sichrovsky T, Hochman JS. Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock. JAMA. 2005;294(4):448-54.
Beyersdorf F, Buckberg GD, Acar C, et al. Cardiogenic shock after acute coronary occlusion. Pathogenesis, early diagnosis, and treatment. Thorac Cardiovasc Surg. 1989;37 (1):28-36.
Chen ZM, Pan HC, Chen YP, et al. Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005;366(9497):1622-32.
Cheng JM, den Uil CA, Hoeks SE, van der Ent M, Jewbali LS, van Domburg RT, et al. Percutaneous left ventricular assist devices vs. intra-aortic balloon pump counterpulsation for treatment of cardiogenic shock: a meta-analysis of controlled trials. Eur Heart J. 2009; 30(17):2102-8.
Choi MS, Sung K, Cho YH. Clinical pearls of venoarterial extracorporeal membrane oxygenation for cardiogenic shock. Korean Circ J. 2019;49 (8):657-77.
De Backer D, Biston P, Devriendt J, et al, for the SOAP II Investigators. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med. 2010;362 (9):779-89.
De Luca L, Colucci WS, Nieminen MS, Massie BM, Gheorghiade M. Evidence-based use of levosimendan in different clinical settings. Eur Heart J. 2006;27(16):1908-20.
Dudzinsk JE, Gnall E, Kowey PR. A review of percutaneous mechanical support devices and strategies. Rev Cardiovasc Med. 2018;19 (1):21-6.
Ellender TJ, Skinner JC. The use of vasopressors and inotropes in the emergency medical treatment of shock. Emerg Med Clin North Am. 2008;26(3):759-86.
Farrar DJ, Lawson JH, Litwak P, Cederwall G. Thoratec VAD system as a bridge to heart transplantation. J Heart Transplant. 1990; 9(4):415-22.
Felker GM, Benza RL, Chandler AB, et al, for the OPTIME-CHF Investigators. Heart failure etiology and response to milrinone in decompensated heart failure: results from the OPTIME-CHF study. J Am Coll Cardiol. 2003; 41 (6):997-1003.
Forrester JS, Wyatt HL, Da Luz PL, Tyberg JV, Diamond GA, Swan HJ. Functional significance of regional ischemic contraction abnormalities. Circulation. 1976;54 (1):64-70.
Fox KA, Steg PG, Eagle KA, Goodman SG, Anderson FA Jr, Granger CB, et al. Decline in rates of death and heart failure in acute coronary syndromes, 1999-2006. JAMA. 2007; 297(17):1892-900.
Fuhrmann JT, Schmeisser A, Schulze MR, Wunderlich C, Schoen SP, Rauwolf T, et al. Levosimendan is superior to enoximone in refractory cardiogenic shock complicating acute myocardial infarction. Crit Care Med. 2008;36(8):2257-66.
Funaro S, La Torre G, Madonna M, et al, for the AMICI Investigators. Incidence, determinants, and prognostic value of reverse left ventricular remodelling after primary percutaneous coronary intervention: results of the Acute Myocardial Infarction Contrast Imaging (AMICI) multicenter study. Eur Heart J. 2009;30(5):566-75.
Garan AR, Eckhardt C, Takeda K, et al. Predictors of survival and ability to wean from short-term mechanical circulatory support device following acute myocardial infarction complicated by cardiogenic shock. Eur Heart J Acute Cardiovasc Care. 2018;(8):755-65.
Garatti A, Russo C, Lanfranconi M, Colombo T, Bruschi G, Trunfio S, et al. Mechanical circulatory support for cardiogenic shock complicating acute myocardial infarction: an experimental and clinical review. ASAIO J. 2007;53(3):278-87.
Gheorghiade M, Gattis WA, Klein L. OPTIME in CHF trial: rethinking the use of inotropes in the management of worsening chronic heart failure resulting in hospitalization. Eur J Heart Fail. 2003;5(1):9-12.
Goldberg RJ, Samad NA, Yarzebski J, Gurwitz J, Bigelow C, Gore JM. Temporal trends in cardiogenic shock complicating acute myocardial infarction. N Engl J Med. 1999; 340(15):1162-8.
Graf T, Desch S, Eitel I, Thiele H. Acute myocardial infarction and cardiogenic shock: pharmacologic and mechanical hemodynamic support pathways. Coron Artery Dis. 2015;26 (6):535-44.
Gruppo Italiano per lo Studio della Streptochi-nasi nell'Infarto Miocardico (GISSI). Long-term effects of intravenous thrombolysis in acute myocardial infarction: final report of the GISSI study. Lancet. 1987;2(8564):871-4.
Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico (GISSI). Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet. 1986;1(8478):397-402.
Hamon M, Agostini D, Le Page O, Riddell JW, Hamon M. Prognostic impact of right ventricular involvement in patients with acute myocardial infarction: meta-analysis. Crit Care Med. 2008;36(7):2023-33.
Hasdai D, Califf RM, Thompson TD, Hochman JS, Ohman EM, Pfisterer M, et al. Predictors of cardiogenic shock after thrombolytic therapy for acute myocardial infarction. J Am Coll Cardiol. 2000;35(1):136-43.
Hochman JS, Sleeper LA, Webb JG, et al, for the SHOCK Investigators. Early revascularization and long-term survival in cardiogenic shock complicating acute myocardial infarction. JAMA. 2006;295 (21):2511-5.
Hochman JS, Sleeper LA, White HD, Dzavik V, Wong SC, Menon V, et al. One-year survival following early revascularization for cardiogenic shock. JAMA. 2001;285(2):190-2.
Jeger RV, Harkness SM, Ramanathan K, et al, for the SHOCK Investigators. Emergency revascularization in patients with cardiogenic shock on admission: a report from the SHOCK trial and registry. Eur Heart J. 2006;27(6):664-70.
Jeger RV, Lowe AM, Buller CE, Pfisterer ME, Dzavik V, Webb JG, et al. Hemodynamic parameters are prognostically important in cardiogenic shock but similar following early revascularization or initial medical stabilization: a report from the SHOCK Trial. Chest. 2007;132(6):1794-803.
Jeger RV, Radovanovic D, Hunziker PR, Pfisterer ME, Stauffer JC, Erne P, et al. Ten-year trends in the incidence and treatment of cardiogenic shock. Ann Intern Med. 2008; 149(9):618-26.
Kolte D, Khera S, Aronow WS, et al. Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States. J Am Heart Assoc. 2014;3(1):e000590.
Koprivanac M, Kelava M, Soltesz E, et al. Advances in temporary mechanical support for treatment of cardiogenic shock. Expert Rev Med Devices. 2015;(6):689-702.
Kunadian V, Qiu W, Ludman P, et al, for the National Institute for Cardiovascular Outcomes Research. Outcomes in patients with cardiogenic shock following percutaneous coronary intervention in the contemporary era: an analysis from the BCIS database (British Cardiovascular Intervention Society). JACC Cardiovasc Interv. 2014;(12):1374-85.
McGugan PL. The role of venoarterial extracorporeal membrane oxygenation in postcardiotomy cardiogenic shock. Crit Care Nurs Clin North Am. 2019;(3):419-36.
Menon V, White H, LeJemtel T, et al. The clinical profile of patients with suspected cardiogenic shock due to predominant left ventricular failure: a report from the SHOCK Trial Registry. SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK?. J Am Coll Cardiol. 2000; 36 (3 suppl A):1071-6.
Naples RM, Harris JW, Ghaemmaghami CA. Critical care aspects in the management of patients with acute coronary syndromes. Emerg Med Clin North Am. 2008;26(3):685-702.
O'Gara PT, Kushner FG, Ascheim DD, et al, for the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127(4):e362-425.
Picard MH, Davidoff R, Sleeper LA, and the SHOCK Trial investigators. SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK. Echocardiographic predictors of survival and response to early revascularization in cardiogenic shock. Circulation. 2003;107(2):279-84.
Ponikowski P, Voors AA, Anker SD, et al, Authors/Task Force Members. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37 (27):2129-200.
Ramanathan K, Farkouh ME, Cosmi JE, French JK, Harkness SM, Džavík V, et al. Rapid complete reversal of systemic hypoperfusion after intra-aortic balloon pump counterpulsation and survival in cardiogenic shock complicating an acute myocardial infarction. Am Heart J. 2011;162(2):268-75.
Reynolds HR, Hochman JS. Cardiogenic shock: current concepts and improving outcomes. Circulation. 2008;117(5):686-97.
Rihal CS, Naidu SS, Givertz MM, et al. SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention. J Am Coll Cardiol. 2015;65 (19):e7-e26.
Rose EA, Gelijns AC, Moskowitz AJ, Heitjan DF, Stevenson LW, Dembitsky W, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001; 345(20):1435-43.
Sanborn TA, Sleeper LA, Bates ER, et al. Impact of thrombolysis, intra-aortic balloon pump counterpulsation, and their combination in cardiogenic shock complicating acute myocardial infarction: a report from the SHOCK Trial Registry. SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK?. J Am Coll Cardiol. 2000; 36(3 Suppl A):1123-9.
Shin TG, Choi JH, Jo IJ, Sim MS, Song HG, Jeong YK, et al. Extracorporeal cardiopulmonary resuscitation in patients with inhospital cardiac arrest: A comparison with conventional cardiopulmonary resuscitation. Crit Care Med. 2011;39(1):1-7.
Sjauw KD, Engstrom AE, Vis MM, et al. A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines?. Eur Heart J. 2009;30(4):459 -68.
Slottosch I, Liakopoulos O, Kuhn E, Deppe AC, Scherner M, Madershahian N, et al. Outcomes after peripheral extracorporeal membrane oxygenation therapy for postcardiotomy cardiogenic shock: a single-center experience. J Surg Res. 2013;181 (2):e47-55.
Susen S, Rauch A, Van Belle E, Vincentelli A, Lenting PJ. Circulatory support devices: fundamental aspects and clinical management of bleeding and thrombosis. J Thromb Haemost. 2015;(10):1757-67.
Thiele H, Zeymer U, Neumann FJ, et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med. 2012;367(14):1287-96.
van Diepen S, Katz JN, Albert NM, et al, for the American Heart Association Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Mission: Lifeline. Contemporary management of cardiogenic shock: a scientific statement From the American Heart Association. Circulation. 2017;136(16):e232-68.
Windecker S. Percutaneous left ventricular assist devices for treatment of patients with cardiogenic shock. Curr Opin Crit Care. 2007;13(5):521-7.