Pathophysiology of cardiogenic shock. Quantification of myocardial necrosis, clinical, pathologic and electrocardiographic correlations

D. R. Alonso, S. Scheidt, M. Post, T. Killip

Research output: Contribution to journalArticlepeer-review

252 Scopus citations

Abstract

Clinical and pathologic data were correlated in 22 patients with cardiogenic shock and 10 'control' patients who died suddenly after infarction without shock. A pathologic technique of ventricular mapping allowed quantification of recent as well as old infarction. Total left ventricular (LV) damage averaged 51% (range 35-68%) in the shock patients and 23% (range 14-31%) in the control group. Shock was associated with recent infarction (all 22 patients), old infarction (21 patients) and extension of infarction (18 patients). Extension, often in a subepicardial manner, averaged 6% of LV mass (range 3-10%) in 18 patients with shock. It preceded shock in 4, coincided with the onset of shock in 6, and followed shock in 7 patients with shock. In contrast, small extensions averaging 2% of LV mass were found in 3, and multiple recent infarctions in 2 control patients. Although progressive myocardial damage was a common pathologic finding, it was infrequently recognized clinically. The electrocardiogram reflected evidence of recent infarction in 56%, old infarction in 31%, and extension in only 30% of patients. These data suggest that appropriate early therapeutic intervention might limit myocardial damage by preventing extension or reinfarction. Since shock was best correlated with total LV damage, such limitation of infarction might reduce the incidence and mortality of cardiogenic shock.

Original languageEnglish
Pages (from-to)588-596
Number of pages9
JournalCirculation
Volume48
Issue number3
DOIs
StatePublished - 1973
Externally publishedYes

Fingerprint

Dive into the research topics of 'Pathophysiology of cardiogenic shock. Quantification of myocardial necrosis, clinical, pathologic and electrocardiographic correlations'. Together they form a unique fingerprint.

Cite this