Related Experiment Video
Updated: Feb 4, 2026
Point-of-Care Ultrasound: A Review of Ultrasound Parameters for Predicting Difficult Airways
Published on: April 7, 2023
Cardiac Shock Care Centers: JACC Review Topic of the Week
Tanveer Rab1, Supawat Ratanapo1, Karl B Kern2
1Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Insights
Cardiogenic shock after heart attack is rising, with high mortality. Early mechanical support before reperfusion may improve survival in acute myocardial infarction patients.
Area of Science:
- Cardiology
- Critical Care Medicine
Background:
- Cardiogenic shock following acute myocardial infarction (AMI) remains a critical challenge with high mortality.
- Despite advances, treatment strategies lack standardization, particularly regarding mechanical circulatory support (MCS) and percutaneous coronary intervention (PCI).
Purpose of the Study:
- To propose a systems of care approach and treatment pathway for patients experiencing AMI complicated by cardiogenic shock.
- To address the need for standardized protocols in managing this high-risk patient population.
Main Methods:
- Review of current literature and clinical practices.
- Analysis of outcomes from prospective registries and centers utilizing early MCS.
- Development of a proposed treatment algorithm.
Main Results:
- Emerging evidence suggests improved survival with advanced MCS placement prior to reperfusion therapy (PCI).
- Lack of standardized protocols hinders optimal patient management and outcomes.
Conclusions:
- A structured systems of care approach, including a defined treatment pathway, is crucial for managing AMI with cardiogenic shock.
- Timely implementation of MCS and PCI, guided by standardized protocols, holds promise for improving survival rates.
Abstract:
Despite advances over the past decade, the incidence of cardiogenic shock secondary to acute myocardial infarction has increased, with an unchanged mortality near 50%. Recent trials have not clarified the best strategies in treatment. While dedicated cardiac shock centers are being established, there are no standardized agreements on the utilization of mechanical circulatory support and the timeliness of percutaneous coronary intervention strategies. In some centers and prospective registries, outcomes after placement of advanced mechanical circulatory support prior to reperfusion therapy with percutaneous coronary intervention have been encouraging with improved survival. Here, we suggest systems of care with a treatment pathway for patients with acute myocardial infarction complicated by cardiogenic shock.
Related Concept Videos
01:13Patient-centered Care
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:10Review and Preview
Percentiles are a type of fractile that partition data into...
01:13Review and Preview
01:16Shock Waves
When the source's speed approaches the speed of sound, constructive interference between successive wavefronts emitted by the source occurs immediately behind it. Initially, scientists believed that this constructive interference would result in such high...