Update on cardiogenic shock: from detection to team management

Curr Opin Cardiol. 2023 Mar 1;38(2):108-115. doi: 10.1097/HCO.0000000000001017. Epub 2023 Jan 16.

Abstract

Purpose of review: The following review is intended to provide a summary of contemporary cardiogenic shock (CS) profiling and diagnostic strategies, including biomarker and hemodynamic-based (invasive and noninvasive) monitoring, discuss clinical differences in presentation and trajectory between acute myocardial infarction (AMI)-CS and heart failure (HF)-CS, describe transitions to native heart recovery and heart replacement therapies with a focus on tailored management and emerging real-world data, and emphasize trends in team-based initiatives and interventions for cardiogenic shock including the integration of protocol-driven care.

Recent findings: This document provides a broad overview of contemporary scientific consensus statements as well as data derived from randomized controlled clinical trials and observational registry working groups focused on cardiogenic shock management.

Summary: This review highlights the increasingly important role of pulmonary artery catheterization in AMI-CS and HF-CS cardiogenic shock and advocates for routine application of algorithmic approaches with interdisciplinary care pathways. Cardiogenic shock algorithms facilitate the integration of clinical, hemodynamic, and imaging data to determine the most appropriate patient hemodynamic support platform to achieve adequate organ perfusion and decongestion.

Publication types

  • Review

MeSH terms

  • Cardiotonic Agents
  • Heart Failure*
  • Hemodynamics
  • Humans
  • Myocardial Infarction* / therapy
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / therapy

Substances

  • Cardiotonic Agents