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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

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Contemporary Management of Cardiogenic Shock Complicating Acute Myocardial Infarction

Leonardo De Luca1,2, Raffaella Mistrulli1, Riccardo Scirpa1

  • 1Department of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, Italy.

Journal of Clinical Medicine
|March 29, 2023
PubMed

Insights

Management of cardiogenic shock (CS) after acute myocardial infarction (AMI) lacks evidence. This review critically overviews revascularisation, medical treatments, and mechanical circulatory support (MCS) for improved CS patient outcomes.

Area of Science:

  • Cardiology
  • Critical Care Medicine

Background:

  • Acute myocardial infarction (AMI) with cardiogenic shock (CS) has high mortality.
  • Limited evidence-based guidelines exist for CS management, relying on registry data.
  • Varied understanding of mechanical circulatory support (MCS) leads to inconsistent CS treatment.

Purpose of the Study:

  • To critically review current literature on managing CS complicating AMI.
  • To summarize recent evidence on revascularization, pharmacotherapy, and MCS in CS.

Main Methods:

  • Literature review of studies on AMI with CS.
  • Analysis of revascularization strategies.
  • Evaluation of pharmacological treatments.
  • Assessment of temporary mechanical circulatory support (MCS) devices.

Main Results:

  • Suboptimal outcomes persist for AMI patients, particularly those with CS.
  • Significant mortality (40-50%) associated with CS.
  • Underutilization or overutilization of MCS devices due to knowledge gaps.

Conclusions:

  • There is a critical need for evidence-based strategies in CS management.
  • Further research is required to optimize revascularization, medical therapy, and MCS use.
  • Standardizing CS treatment protocols is essential for better patient outcomes.

Keywords:
acute myocardial infarctioncardiogenic shockmechanical circulatory supports

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