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Chapter-058 Cardiogenic Shock in Acute Myocardial Infarction

BOOK TITLE: CSI: Cardiology Update 2014

Author
1. Chhabria Rahul
2. Mehta Ashwin B
ISBN
9789351526186
DOI
10.5005/jp/books/12415_59
Edition
1/e
Publishing Year
2015
Pages
5
Author Affiliations
1. Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India, Jaslok Hospital and Research Centre, Mumbai, Maharashra, India
2. Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India, Jaslok Hospital and Research Centre, Mumbai, Maharashra, India
Chapter keywords
Cardiogenic shock, acute myocardial infarction, hypotension, systolic arterial pressure, cardiac index, complete blood counts, liver function, bedside 2D echo with Doppler, pharmacotherapy, mechanical support devices

Abstract

Cardiogenic shock (CS) is one of the most common causes of death after an acute myocardial infarction (AMI). In this chapter CS is discussed in detail along with its definition, incidence, pathophysiology, diagnosis, management and treatment. Diagnosis of CS is predominantly clinical and it is characterized by marked and persistent hypotension, with systolic arterial pressure lower than 90 mm Hg and marked reduction of cardiac index in the face of elevated LV filling pressure. Along with diagnosis of complete blood counts, renal and liver function tests, coagulation profile, ECG and bedside 2D echo with Doppler. In case of a medical emergency, CS can be managed by C→A→B, i.e. circulation, airway and breathing. The treatment of CS in AMI comprises of three components i.e. pharmacotherapy, mechanical support devices and reperfusion. Early PCI of culprit artery with stent is essential which will make remarkable differences in survival.

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