Shock: A Review of Current Therapies

Cardiogenic shock is often a devastating consequence of acute myocardial infarction (MI) and portends to significant mortality and morbidity. Despite improvements in expediting the time to treatment and enhancements in available medical therapy and reperfusion techniques, cardiogenic shock remains themost commoncause ofmortality followingMI. Post-MI cardiogenic shockmost commonly occurs as a consequence of severe left ventricular dysfunction. Right ventricular (RV)MImust also be considered. Mechan-ical complications including acute mitral regurgitation, ventricular septal rupture, and ventricular free-wall rupture can also lead to cardiogenic shock. Rapid diagnosis of cardiogenic shock and its underlying cause is pivotal to delivering definitive therapy. Intravenous vasoactive agents and mechanical support devices may temporize the patient’s hemodynamic status until definitive therapy by percu-taneous or surgical intervention can be performed. Despite prompt management, post-MI cardiogenic shock mortality remains high