Cardiogenic shock - diagnostic and therapeutic options in the light of new scientific data

Shock is a manifestation of circulatory failure related to an inadequate supply of oxygenated blood to the tissues. One type of shock is cardiogenic shock resulting from abnormalities of myocardial structure and function, impairment of mechanical function of the heart, or arrhythmia. Most commonly, cardiogenic shock is due to an acute myocardial infarction, particularly involving the anterior wall. However, establishing the diagnosis of cardiogenic shock and determining its aetiology is not always easy. Techniques of invasive haemodynamic monitoring, measurements of specific biomarkers, and noninvasive bedside echocardiography may be helpful. The effectiveness of shock management depends on the ability to institute appropriate therapy rapidly and to remove the underlying aetiologic factor(s). We present a state-of-the-art review of basic approaches used for the diagnosis and management of cardiogenic shock.