The Management of Cardiogenic Shock and Hemodynamic Support Devices and Techniques

Cardiogenic shock is defined as a clinical condition where there is inadequate end-organ perfusion due to failure of the heart to pump blood in adequate quantities. Prolonged tissue hypoperfusion may lead to end-organ damage, multi-organ failure, and often death. The incidence of cardiogenic shock after myocardial infarction appears to be lowering from about 10% in the 1970s and 80s to about 5–6% in the current era, potentially as a result of improvement in time-to-reperfusion and as a result of better techniques for reperfusion (primary percutaneous coronary intervention compared with thrombolysis). Nonetheless, mortality after cardiogenic shock remains as high as 50% in contemporary cohorts. The management of cardiogenic shock includes the judicious use of several mechanical circulatory support devices.