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Semin Respir Crit Care Med 2011; 32(5): 598-606
DOI: 10.1055/s-0031-1287869
© Thieme Medical Publishers

Cardiovascular Failure and Cardiogenic Shock

Ankitkumar K. Patel1 , Steven M. Hollenberg1
  • 1Cardiology and Critical Care Medicine, Cooper University Hospital, Camden, New Jersey
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Publication History

Publication Date:
11 October 2011 (online)

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ABSTRACT

Cardiovascular system failure is commonly faced by the intensivist. Heart failure can occur due to a host of predisposing cardiac disorders or as secondary effects of systemic illness. When the heart is unable to provide an adequate cardiac output to maintain adequate tissue perfusion, cardiogenic shock ensues. Without prompt diagnosis and appropriate management, these patients have significant morbidity and mortality, with in-hospital mortality approaching 60% for all age groups. Accurate and rapid identification of cardiogenic shock as a medical emergency, with expeditious implementation of appropriate therapy, can lead to improved clinical outcomes. In this review, we discuss optimal strategies for diagnosis and monitoring of cardiogenic shock. We discuss the diverse therapeutic strategies employed for cardiogenic shock, including pharmacological (e.g., vasoactive agents, fibrinolytic agents), mechanical (e.g., intraaortic balloon pumps, left ventricular assist devices, percutaneous coronary intervention [PCI]), and surgical approaches such as coronary artery bypass graft (CABG), valvular repair or replacement (e.g., for acute mitral regurgitation, ventricular septal rupture, or free wall rupture).

KEYWORDS

Cardiogenic shock - intensive care - myocardial infarction - echocardiography - right heart catheterization - vasopressor therapy - inotropic therapy

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Steven M HollenbergM.D. 

Cardiology and Critical Care Medicine, Cooper University Hospital, One Cooper Plaza

366 Dorrance, Camden, NJ 08103

Email: Hollenberg-Steven@cooperhealth.edu