[Cardiogenic shock: from early diagnosis to multiparameter monitoring]

Area of Science:

• Cardiology
• Critical Care Medicine

Background:

• Cardiogenic shock (CS) is a severe condition characterized by reduced cardiac output and tissue hypoxia, despite adequate fluid status.
• Acute myocardial infarction is the most frequent cause of CS, with high mortality rates persisting even with emergency revascularization.
• Diagnosing CS can be challenging, requiring a combination of clinical, hemodynamic, and biochemical assessments.

Purpose of the Study:

• To summarize key aspects of cardiogenic shock diagnosis, etiology, and pathophysiology.
• To emphasize the importance of macro- and microhemodynamic parameters in CS management.
• To highlight the necessity of specialized teams and multidisciplinary platforms for effective CS treatment.

Main Methods:

• Review of diagnostic criteria for cardiogenic shock.
• Analysis of etiological factors, focusing on acute myocardial infarction.
• Discussion of pathophysiological mechanisms, including hemodynamic alterations.
• Emphasis on macro- and microhemodynamic monitoring for diagnosis and treatment.

Main Results:

• Cardiogenic shock necessitates a comprehensive diagnostic approach integrating clinical, hemodynamic, and biochemical data.
• Despite advancements, refractory CS continues to present significant therapeutic challenges and high mortality.
• Effective management relies on specialized medical expertise and integrated technical platforms.

Conclusions:

• Accurate diagnosis and understanding of pathophysiology are crucial for managing cardiogenic shock.
• Hemodynamic monitoring, encompassing both macro- and microcirculation, is essential for guiding treatment decisions.
• Multidisciplinary collaboration and specialized care are vital for improving outcomes in patients with cardiogenic shock.