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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Updated: May 6, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Optimizing cardiogenic shock outcomes: A system-based network approach.

Federica Pesce1, Carlotta Sorini Dini1, Francesca Maria Righini1

  • 1Cardiac Intensive Care Unit, Cardio-Thoracic-Vascular Department, University Siena Hospital, Siena, Italy.

International Journal of Cardiology
|May 4, 2026
PubMed
Summary
This summary is machine-generated.

A structured regional network for cardiogenic shock (CS) patients demonstrated low in-hospital mortality. This approach, involving early mechanical circulatory support (MCS), improved outcomes regardless of direct or transferred admission to the shock center.

Keywords:
Cardiac intensive care unitCardiogenic shockMechanical circulatory supportOutcomeRegional networkShock team

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Health Systems Research

Background:

  • Cardiogenic shock (CS) remains a critical condition with high mortality rates.
  • Structured regional networks aim to standardize care and improve outcomes in CS.
  • This study investigates the effectiveness of a regional CS network.

Purpose of the Study:

  • To evaluate the impact of a structured regional cardiogenic shock network on in-hospital mortality.
  • To assess clinical outcomes in patients managed within this network.
  • To compare outcomes between directly admitted (hub) and transferred (spoke) CS patients.

Main Methods:

  • Prospective observational study enrolling CS patients (SCAI stage C-E) from September 2020 to November 2024.
  • Patients were categorized into hub (direct admission) and spoke (transferred from network hospitals) groups.
  • Data on demographics, etiology, severity, interventions, and outcomes were collected.

Main Results:

  • 145 CS patients were enrolled; 61.4% were transferred from network hospitals.
  • Despite a high-risk profile (48.3% SCAI D+E), 73.5% achieved successful outcomes (discharge or cardiac replacement therapy).
  • Overall in-hospital mortality was 26.5%; a vaso-inotropic score >21 at 48h predicted mortality (AUC=0.722).

Conclusions:

  • The structured regional network for CS showed a low in-hospital mortality rate.
  • No significant difference in outcomes was observed between hub and spoke groups.
  • Multidisciplinary management and early mechanical circulatory support (MCS) implantation likely contributed to favorable outcomes.