Post-Myocardial Infarction Cardiogenic Shock Is a Systemic Illness in Need of Systemic Treatment

Early observations of cardiogenic shock as a systemic clinical syndrome were first described in 1942. Today, cardiogenic shock remains the leading cause of death among patients hospitalized for myocardial infarction (MI). Mortality rates in post-MI cardiogenic shock approach 50% despite rapid revasc...

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Published inJournal of the American College of Cardiology Vol. 59; no. 7; pp. 644 - 647
Main Authors Stegman, Brian M., MD, Newby, L. Kristin, MD, MHS, Hochman, Judith S., MD, Ohman, E. Magnus, MD
Format Journal Article
LanguageEnglish
Published New York Elsevier Inc 14.02.2012
Elsevier Limited
Subjects
acute myocardial infarction
Angioplasty
cardiogenic shock
Cardiology
Cardiovascular
Heart attacks
Internal Medicine
Medical research
Mortality
Rodents
therapeutic hypothermia
treatment
treatment
myocardial infarction
cardiogenic shock
LV
left ventricular
therapeutic hypothermia
MI
acute myocardial infarction
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Summary:Early observations of cardiogenic shock as a systemic clinical syndrome were first described in 1942. Today, cardiogenic shock remains the leading cause of death among patients hospitalized for myocardial infarction (MI). Mortality rates in post-MI cardiogenic shock approach 50% despite rapid revascularization, optimal medical care, and use of mechanical support. New therapeutic strategies with global systemic effects may offer advances in treatment and outcome in post-MI cardiogenic shock. Therapeutic hypothermia for post-MI cardiogenic shock has multiple potentially beneficial physiologic effects, including the potential to improve post-ischemic cardiac function and hemodynamics, decrease myocardial damage, and reduce end-organ injury from prolonged hypoperfusion. Available data in animal models of post-MI cardiogenic shock and ischemia/reperfusion injury and small case series of human patients with cardiogenic shock suggest its promise as a potential therapeutic strategy for cardiogenic shock in the post-MI setting. We hypothesize that systemic therapeutic hypothermia could decrease morbidity and mortality in post-MI patients with cardiogenic shock and warrants study a new treatment that could be widely available at hospitals worldwide.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2011.11.010