UMEM Educational Pearls

Category: Cardiology

Title: cardiogenic shock

Keywords: hypothermia, cardiogenic shock (PubMed Search)

Posted: 3/25/2012 by Amal Mattu, MD (Updated: 12/7/2021)
Click here to contact Amal Mattu, MD

Cardiogenic shock pearls from Dr. Semhar Tewelde:

1. CS is most commonly secondary to a large MI where > 40% of the myocardium is involved; however mechanical, valvular, dysrhythmogenic, and infectious etiologies should also be considered: papillary or chordal dysfunction, free wall or septal defects disease, insuffiency of any valve, myopericarditis, endocarditis, Tako-tsubo, end stage cardiomyopathy, and tamponade.
2. Incidence of 5-10% STEMI and 2.5-5% NSTEMI
3. Mortality ~50%
4. Immediate coronary reperfusion is the best treatment (NNT 8). Medical therapy is a distant second choice in management, with reperfusion and pressors as needed. Early intra-aortic balloon pump use is key.
5. Recent case reports have shown imporved outcomes when induced hypothermia was used in patients refractory to traditional therapy with pressors/inotropes/IABP.