Abstract
The objective of this article is a review of cardiogenic shock, including its pathophysiology, symptoms and signs, and current treatment. The study was done through the analysis of randomized and multicentric studies. Diverse articles about cardiogenic shock were also used. Cardiovascular diseases are the major cause of death in the world. Of these deaths, the majority are due to heart attacks and stroke. Cardiogenic shock is the most critical expression of coronary artery disease because is high morbidity and mortality. Cardiogenic shock continúes to complícate less than 10% of myocardial infarction but his mortality could be more than 80% when the treatment is inappropriate. Systolic and diastolic ventricular dysfunctions are the pathophysiologic of cardiogenic shock and the cause is the acute aggravation of coronary artery disease by insuffcient irrigation on the myocardial tissue (total or partial occlusion) as well by systemic infammatory response syndrome. The leading clinical symptoms are hypotension and hypoperfusion (oliguria, cyanosis, change in mental status, cold extremities) and the hemodynamic changes are just additional information to support the diagnosis and to defne the optimal treatment. The treatment also includes correction of hypoxia, acidosis and hydroelectrolytics disturbances. Adjunct pharmacologic therapy usually based on catecholamines and phosphodiesterase inhibitors are useful in the treatment but the survival is modifed only by early revascularization (interventional or surgical). Implantation of an intraortic balloon pump is justifed. Temporary mechanical circulatory support with left ventricular assist devices is indicated as a bridge to heart transplantation. The successful treatment result by prompt recognizes patients in risk and an invasive approach with early revascularization. The goal of any therapy in cardiogenic shock is to restore nutritional blood fow and prevent further damage of vital organs.
Key words: Acute myocardial infarction. Cardiogenic shock. Coronary disease percutaneous coronary intervention.
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