Document Detail


Management of cardiogenic shock due to acute coronary syndromes.
MedLine Citation:
PMID:  15793600     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite advances in the treatment of patients with acute coronary syndromes, there has been no significant decrease in the incidence of cardiogenic shock, while its mortality remains frustratingly high. Shock is a progressive state of hypotension (systolic blood pressure < 90 mm Hg) lasting at least 30 minutes, which leads to systemic hypoperfusion. It is more common in patients with ST-segment elevation myocardial infarction than in patients with other acute coronary syndromes. Revascularization is associated with better outcomes than intensive medical therapy, especially in patients < 75 years of age with cardiogenic shock. Adjunctive therapies include inotropes, vasopressor therapy, intra-aortic balloon pump counterpulsation, and IIb/IIIa blockade to prevent no-reflow phenomenon during primary percutaneous transluminal coronary angioplasty. Other adjunctive therapies which are investigated are improved mechanical support devices, and as medical therapy for myocyte protection nicorandil, glucose/insulin/potassium infusions and direct inhibition of Na+/H+ exchanger.
Authors:
Konstantina P Bouki; Georgios Pavlakis; Evaggelos Papasteriadis
Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Angiology     Volume:  56     ISSN:  0003-3197     ISO Abbreviation:  Angiology     Publication Date:    2005 Mar-Apr
Date Detail:
Created Date:  2005-03-28     Completed Date:  2005-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0203706     Medline TA:  Angiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  123-30     Citation Subset:  IM    
Affiliation:
1st Department of Cardiology, General Hospital of Nikea, Pireaus, Greece. epapak@tee.gr
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MeSH Terms
Descriptor/Qualifier:
Cardiotonic Agents / therapeutic use
Coronary Disease / complications*,  mortality,  therapy
Humans
Intra-Aortic Balloon Pumping
Myocardial Revascularization
Platelet Aggregation Inhibitors / therapeutic use
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors
Shock, Cardiogenic / etiology,  mortality,  therapy*
Survival Rate
Syndrome
Treatment Outcome
Vasoconstrictor Agents / therapeutic use
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 0/Vasoconstrictor Agents

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