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Myocardial infarct size and cardiogenic shock

P Grande, C Christiansen, B F Hansen

    European Heart Journal
    |May 1, 1983
    PubMed

    Insights

    Cardiogenic shock in acute myocardial infarction (AMI) patients is linked to larger infarct sizes, but significant overlap exists. Even small infarcts can cause shock, particularly with other cardiac issues.

    Area of Science:

    • Cardiology
    • Cardiovascular Research
    • Medical Science

    Background:

    • Cardiogenic shock is a severe complication of acute myocardial infarction (AMI).
    • The precise relationship between infarct size and the development of cardiogenic shock requires further elucidation.

    Purpose of the Study:

    • To investigate the association between estimated infarct size and the occurrence of cardiogenic shock in patients with AMI.
    • To explore the role of infarct characteristics in mortality among shock patients.

    Main Methods:

    • In vivo infarct size estimation using serum CK-MB levels in 317 AMI patients.
    • Histological and histochemical analysis of heart autopsy in 23 non-survivors.
    • Comparison of infarct sizes between patients with and without cardiogenic shock.

    Main Results:

    • Patients with cardiogenic shock exhibited a significantly larger median infarct size (1035 U/l) compared to those without shock (669 U/l).
    • A substantial overlap in infarct size was observed between the two groups.
    • Autopsy findings revealed that even small subendocardial infarcts could lead to shock, especially in the presence of severe coronary artery disease or infarction fibrosis.

    Conclusions:

    • While larger infarct size is associated with cardiogenic shock in AMI, it is not the sole determinant.
    • Infarct size in survivors of cardiogenic shock and those who died from shock was similar.
    • Mortality from shock was comparable to mortality from other cardiac causes, irrespective of infarct size.

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