Document Detail


Management of myocardial infarction shock: current status.
MedLine Citation:
PMID:  2644797     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Major advances have occurred over the last two decades in the management of myocardial infarction shock, increasing the overall in-hospital survival rate from approximately 15% to more than 50% at the present time with aggressive methods of interventional cardiology. The widespread use of intravenous thrombolytic therapy during the early hours of myocardial infarction has resulted in a decreasing incidence of shock with first myocardial infarctions. Three mechanisms bring about cardiogenic shock: (1) extensive aggregate systolic left ventricular dysfunction, (2) extensive right ventricular infarction, and (3) mechanical defects of the left and/or right ventricles attendant to ischemic dysfunction or rupture. To permit survival in cardiogenic shock, even with maximally aggressive therapy, diagnostic evaluation must be carried out concurrently with clinical stabilization of the patient. IABC is the mainstay for supporting the patient in shock during further efforts at diagnosis and definitive therapy. Definitive therapy for cardiogenic shock may include percutaneous transluminal coronary angioplasty, emergent bypass surgery, or repair of a mechanical defect. This report details the current status of knowledge with respect to pathogenesis, recognition, and definitive treatment of myocardial infarction shock.
Authors:
T L Schreiber; D H Miller; B Zola
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American heart journal     Volume:  117     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1989 Feb 
Date Detail:
Created Date:  1989-03-17     Completed Date:  1989-03-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  435-43     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, New York Hospital-Cornell Medical Center, NY 10021.
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MeSH Terms
Descriptor/Qualifier:
Emergency Medical Services
Evaluation Studies as Topic
Heart Catheterization
Humans
Myocardial Infarction / complications*,  therapy
Shock, Cardiogenic / diagnosis,  etiology,  therapy*

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