| Update on the management of cardiogenic shock. | |
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MedLine Citation:
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PMID: 16943721 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Cardiogenic shock is a life-threatening emergency that occurs frequently with acute coronary syndromes. If rapid myocardial reperfusion following acute myocardial infarction is not obtained, either with thrombolytics or by revascularization, cardiogenic shock frequently develops and the mortality rate is high. This review summarizes recent advances in the pathophysiology, incidence and treatment of cardiogenic shock. Particular attention is given to pharmacologic advances. RECENT FINDINGS: Cardiogenic shock continues to occur in 5-10% of patients who suffer a myocardial infarction and the mortality remains over 50% in most studies. Treatment preference is referral to a cardiac center capable of reperfusion using multiple therapies. While no delay in reperfusion is acceptable, emphasis on implementing supportive treatment such as vasopressors, inotropes, and fluids remains critical. There is a wide variance in treatment standards despite established guidelines. Overall mortality from cardiogenic shock has decreased but the incidence remains unchanged. SUMMARY: Emerging pharmacological interventions designed to counteract the underlying proinflammatory pathophysiologic mechanisms may, in combination with early revascularization, result in improved patient outcomes, but there is no magic bullet on the horizon. Attention to the timeliness of transport and treatment of patients with a focus on revascularization is required for cardiogenic shock patients. |
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Authors:
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Henry J Mann; Paul E Nolan |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in critical care Volume: 12 ISSN: 1070-5295 ISO Abbreviation: Curr Opin Crit Care Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-08-31 Completed Date: 2007-01-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9504454 Medline TA: Curr Opin Crit Care Country: United States |
Other Details:
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Languages: eng Pagination: 431-6 Citation Subset: IM |
Affiliation:
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University Of Minnesota, College of Pharmacy, Department of Experimental and Clinical Pharmacology, Minneapolis, Minnesota, USA. HMann@umn.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Balloon Dilatation Coronary Artery Bypass Humans Inflammation Mediators / adverse effects*, antagonists & inhibitors Reperfusion / methods* Shock, Cardiogenic* / mortality, physiopathology, therapy Thrombolytic Therapy* Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Inflammation Mediators |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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