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Updated: Jul 7, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

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

Published on: June 12, 2021

Management of Spontaneous Coronary Dissection Complicated by Cardiogenic Shock: A Case Report

Daniel Grüter1,2, Thomas Seiler1, Chiara Schaffner1

  • 1Cardiology Division Heart Center-Luzerner Kantonsspital Luzern Switzerland.

Clinical Case Reports
|July 6, 2026
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) causing cardiogenic shock (CS) can be challenging. Conservative management with a temporary ventricular assist device led to complete recovery in a SCAD patient with CS.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS).
  • Optimal treatment for SCAD in cardiogenic shock (CS) remains debated.
  • SCAD can lead to severe hemodynamic compromise.

Purpose of the Study:

  • To present a case of extensive multivessel SCAD complicated by cardiogenic shock.
  • To discuss the management considerations for SCAD patients presenting with CS.

Main Methods:

  • Conservative medical management with single antiplatelet therapy and heparin.
  • Temporary mechanical circulatory support with a left ventricular assist device (Impella).
  • Initiation of heart failure therapy upon hemodynamic stabilization.

Main Results:

  • The patient, initially presenting with out-of-hospital cardiac arrest due to SCAD, showed hemodynamic deterioration.
  • Impella implantation successfully stabilized the patient's hemodynamics.
  • The patient achieved complete recovery after weaning from the device and initiating heart failure therapy.

Conclusions:

  • Conservative management, including mechanical circulatory support, can be effective for SCAD patients with CS.
  • This case underscores the importance of individualized treatment strategies for SCAD-associated cardiogenic shock.
  • Prompt recognition and intervention are crucial for improving outcomes in SCAD with CS.

Keywords:
SCADacute coronary syndromeantiplateletscardiogenic shockout‐of‐hospital cardiac arrest

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