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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

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Management of Multivessel Disease and Cardiogenic Shock

Amerjeet S Banning1, Anthony H Gershlick1

  • 1Leicester Cardiovascular Biomedical Research Unit, Department of Cardiovascular Sciences, The National Institute of Health Research (NIHR), University Hospitals of Leicester National Health Service (NHS) Trust, Glenfield Hospital, University of Leicester, Groby Road, Leicester, LE3 9QP, UK.

Interventional Cardiology Clinics
|June 6, 2017
PubMed

Insights

Cardiogenic shock, often from myocardial infarction, involves low cardiac output and organ damage. Complete revascularization for multivessel disease in shock is recommended, but evidence remains limited.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Critical Care Medicine

Background:

  • Cardiogenic shock (CS) is a critical condition characterized by low cardiac output and systemic hypoperfusion.
  • Left ventricular dysfunction due to myocardial infarction is a primary cause of CS.
  • Significant non-infarct related coronary artery stenosis is present in over half of CS cases, potentially worsening hypotension.

Purpose of the Study:

  • To evaluate the role and evidence supporting complete revascularization in patients with cardiogenic shock and multivessel coronary artery disease.

Main Methods:

  • Review of current guidelines and supporting evidence regarding complete revascularization strategies in CS.
  • Analysis of the impact of non-infarct territory ischemia on hemodynamic stability in CS.

Main Results:

  • Multivessel coronary artery disease is common in CS patients.
  • Persistent ischemia in non-infarct territories may exacerbate hypotension.
  • Current guidelines recommend complete revascularization, but the supporting evidence is considered weak.

Conclusions:

  • Complete revascularization is guideline-recommended for CS with multivessel disease.
  • Further robust evidence is needed to solidify the benefits of complete revascularization in this high-risk population.

Keywords:
Cardiogenic shockMyocardial infarctionPercutaneous coronary intervention

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