Post-MI cardiogenic shock, while traditionally thought to carry a mortality > 80%, actually has perhaps half that mortality when patients are treated aggressively with prompt invasive therapy (PCI, possibly CABG). Fibrinolytics have traditionally been discouraged, but authors now indicate that they should be given if all of the following three conditions are present:
PCI will take greater than 90 minutes,
Less than 3 hours have elapsed since onset of STEMI
No contraindications to lytics are present.
Sent on behalf of Dr. Amal Mattu
References
[adapted from: Reynolds HR, Hochman JS. Cardiogenic shock: current concepts and improving outcomes. Circulation 2008;117:686-697.]
