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Sepsis-induced cardiogenic shock: controversies and evidence gaps in diagnosis and management.
J Intensive Care
January 2025
Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA.
Sepsis often leads to vasoplegia and a hyperdynamic cardiac state, with treatment focused on restoring vascular tone. However, sepsis can also cause reversible myocardial dysfunction, particularly in the elderly with pre-existing heart conditions. The Surviving Sepsis Campaign Guidelines recommend using dobutamine with norepinephrine or epinephrine alone for patients with septic shock with cardiac dysfunction and persistent hypoperfusion despite adequate fluid resuscitation and stable blood pressure.
View Article and Find Full Text PDFMechanical Circulatory Support for Acute Myocardial Infarction Cardiogenic Shock: Review and Recent Updates.
J Cardiothorac Vasc Anesth
December 2024
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
Cardiogenic shock (CS) in acute myocardial infarction (AMI) is a life-threatening syndrome characterized by systemic hypoperfusion that can quickly progress to multiorgan failure and death. Various devices and configurations of mechanical circulatory support (MCS) exist to support patients, each with unique pathophysiological characteristics. The Intra-aortic balloon pump can improve coronary perfusion, decrease afterload, and indirectly augment cardiac output.
View Article and Find Full Text PDFClinical outcomes following shock team implementation for cardiogenic shock: a systematic review.
Egypt Heart J
December 2024
Department of Cardiology, West Virginia University, Morgantown, WV, USA.
Background: Cardiogenic shock is a critical cardiac condition characterized by low cardiac output leading to end-organ hypoperfusion and associated with high in-hospital mortality rates. It can manifest following acute myocardial infarction or acute exacerbation of chronic heart failure. Despite advancements, mortality rates remain elevated, prompting interest in multidisciplinary approaches to improve outcomes.
View Article and Find Full Text PDFThe effect of trimetazidine on cardiac haemodynamics and mitochondrial function in wild-type transthyretin amyloidosis.
ESC Heart Fail
December 2024
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Article Synopsis
- The study aimed to evaluate the effects of trimetazidine, an antianginal medication, on heart function in patients with wild-type transthyretin cardiac amyloidosis (ATTRwt).
- Twenty-two participants were enrolled in a randomized, double-blind trial, comparing the effects of trimetazidine to a placebo over four weeks, measuring various cardiovascular and mitochondrial functions.
- The results showed no significant improvements in key cardiac measures, such as pulmonary artery wedge pressure or mitochondrial function, indicating that trimetazidine did not provide benefits to patients with ATTRwt compared to the placebo.
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