Copyright © 2003 by the European Society of Cardiology.
Editorial
Cardiogenic shock: have we really found the magic potion?
Division of Cardiology, University of North Carolina-Chapel Hill Carolina, USA
* Corresponding author. Tel.: +1-919-843-5221; fax: +1-919-966-1743
E-mail address: menon@med.unc.edu
Received 25 April 2003; accepted 30 April 2003
| The first 10% of the full text of this article appears below. |
See doi:10.1016/S1095-668X(03)00193-3for the article to which this editorial refers
The aetiology of cardiogenic shock following an acute myocardial infarction is multi-factorial. It predominantly arises in the setting of a large myocardial infarction that results in diminished stroke volume and a cardiac output that does not meet ensuing demand. Patients with prior myocardial infarction and extensive coronary artery disease are especially vulnerable due to the inability of the remote myocardium to compensate. Strategies to enhance outcome are focused on early definition of coronary anatomy and emergent revascularization while simultaneously providing haemodynamic support with intra-aortic balloon pulsation and vasopressor therapy. The goal of this approach is to restore infarct artery patency, salvage jeopardized myocardium; and prevent irreversible vital end-organ injury. The NHLBI supported SHOCK trial conclusively established the utility of this invasive strategy in a randomized prospective trial.1At 12-months an early revascularization strategyresulted
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