A Standardized and Comprehensive Approach to the Management of Cardiogenic Shock

Behnam N. Tehrani, Alexander G. Truesdell, Mitchell A. Psotka, Carolyn Rosner, Ramesh Singh, Shashank S. Sinha, Abdulla A. Damluji, Wayne B. Batchelor

Research output: Contribution to journalReview articlepeer-review

Abstract

Cardiogenic shock is a hemodynamically complex syndrome characterized by a low cardiac output that often culminates in multiorgan system failure and death. Despite recent advances, clinical outcomes remain poor, with mortality rates exceeding 40%. In the absence of adequately powered randomized controlled trials to guide therapy, best practices for shock management remain nonuniform. Emerging data from North American registries, however, support the use of standardized protocols focused on rapid diagnosis, early intervention, ongoing hemodynamic assessment, and multidisciplinary longitudinal care. In this review, the authors examine the pathophysiology and phenotypes of cardiogenic shock, benefits and limitations of current therapies, and they propose a standardized and team-based treatment algorithm. Lastly, they discuss future research opportunities to address current gaps in clinical knowledge.

Original languageEnglish (US)
Pages (from-to)879-891
Number of pages13
JournalJACC: Heart Failure
Volume8
Issue number11
DOIs
StatePublished - Nov 2020
Externally publishedYes

Keywords

  • acute decompensated heart failure
  • acute myocardial infarction
  • cardiogenic shock
  • mechanical circulatory support
  • multidisciplinary care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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