Ischaemic cardiogenic shock

The recognition of cardiogenic shock in the setting of myocardial ischaemia has important prognostic and therapeutic implications. Resuscitative efforts should focus on stabilizing circulatory and respiratory function, with early restoration of coronary blood flow to avoid multi-organ dysfunction and death. However, despite recent progress, the mortality rate remains high, in the order of 40–50%. This article highlights several key recent advances in the management of ischaemic cardiogenic shock, including the use of early bedside echocardiography to confirm the diagnosis, and culprit only lesion strategies of early revascularization. Furthermore, we appraise the variety of mechanical cardiac supports that are increasingly being used to assist the management of ischaemic cardiogenic shock in those cases refractory to pharmacological intervention.