Mechanical circulatory support: the last resort in cardiogenic shock?

EuroIntervention 2018;13:e2099-e2101 published online e-edition April 2018. DOI: 10.4244/EIJV13I18A344

Holger Thiele
Holger Thiele1*, MD; Steffen Desch1,2, MD; Suzanne de Waha2,3, MD
1. Heart Centre Leipzig, Department of Cardiology, University Hospital, Leipzig, Germany; 2. German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Luebeck, Germany; 3. University Heart Centre Luebeck, Department of Cardiolog

Cardiogenic shock (CS) occurs in up to 10% of all patients with acute myocardial infarction (AMI) and the mortality rate remains high, approaching 50% depending on the risk profile of the cohort. Standard therapy includes optimal fluid management as well as administration of vasopressors and inotropes on top of a causal treatment of the underlying condition. Although catecholamines play an essential role in the supportive care of CS patients, their benefits on haemodynamics appear to be counterbalanced by adverse effects such as increased myocardial oxygen demand, arrhythmogenicity, and compromise of tissue microcirculation which may translate into an increased mortality risk1. Mechanical ...

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