Despite advances in the overall management of acute myocardial infarction (AMI), cardiogenic shock in the setting of AMI (CS-AMI) continues to be associated with poor patient outcomes. There are multiple devices that can be used in CS-AMI to support the failing circulation, although their utility in improving outcomes as compared with conventional pharmacotherapy of vasopressors and inotropes remains to be established. This contemporary review provides an update on the evidence base for each of these techniques. In CS-AMI, acute thrombotic occlusion of a major epicardial artery leads to hypoxia and myocardial ischaemia in the territory subtended by that vessel. The resultant regional dysfunction in myocardial contractility can severely compromise stroke volume and result in acute circulatory failure, systemic hypoperfusion, lactic acidosis, multi-organ failure and ultimately death.
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http://dx.doi.org/10.1007/s10741-021-10088-8 | DOI Listing |
J Interv Card Electrophysiol
January 2025
Cardiovascular Department, University of Texas Medical Branch, Galveston, TX, USA.
Background: Ventricular tachycardia (VT) in patients with cardiac sarcoidosis (CS) can lead to sudden cardiac death. The role of ventricular tachycardia ablation (VTA) in CS has been investigated in a few small, single-center, and larger observational studies, but the evidence still needs to be provided. This study aimed to investigate the clinical outcomes of VTA in patients with CS admitted with a diagnosis of VT.
View Article and Find Full Text PDFEur Heart J Acute Cardiovasc Care
December 2024
Department of Cardiology, Angiology, Hemostaseology and Medical Intensive Care, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Background: The impact of systemic inflammation in acute myocardial infarction complicated by cardiogenic shock (AMI-CS) is still a matter of debate. The present ECLS-SHOCK sub-study investigates the association of C-reactive protein (CRP) levels with short-term outcomes in patients with AMI-CS.
Methods: Patients with AMI-CS enrolled in the multicenter, randomized ECLS-SHOCK trial between 2019 and 2022 were included.
J Palliat Med
January 2025
Section of Geriatrics and Palliative Care, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Cardiogenic shock (CS) is one of the leading causes of death in patients with myocardial infarction, myocarditis, and congestive heart failure. The utilization patterns of specialist palliative care (PC) consultation in these patients are currently unknown. To determine the utilization of PC in patients with CS and the overall comorbidities of that population.
View Article and Find Full Text PDFJTCVS Open
December 2024
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
Objective: To develop a model for preoperatively predicting postcardiotomy cardiogenic shock (PCCS) in patients with poor left ventricular (LV) function undergoing cardiac surgery.
Methods: From the Society of Thoracic Surgeons Adult Cardiac Database, 11,493 patients with LV ejection fraction ≤35% underwent isolated on-pump surgery from 2018 through 2019, of whom 3428 experienced PCCS. In total, 68 preoperative clinical variables were considered in machine-learning algorithms trained and optimized using scikit-learn software.
JTCVS Open
December 2024
Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
Objectives: This study aims to investigate the association between interatrial conduction block and postoperative atrial fibrillation, which can precipitate acute cardiopulmonary instability and is associated with subsequent heart failure, stroke, and mortality following cardiac surgery.
Methods: Perioperative 12-channel electrocardiograms from 3405 patients undergoing myocardial revascularization, valve surgery, aortic surgery, or combinations thereof, were considered. Clinical and electrographic parameters were compared between patients with and without atrial fibrillation, and significant variables were analyzed using univariate and multivariate logistic regression.
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