Varpula Marjut, Tierala Ilkka
HYKS/HUS, Meilahden sairaala, kardiologian klinikka, anestesiologian klinikka, teho-osasto.
Duodecim. 2010;126(18):2121-30.
Cardiogenic shock is the most common fatal complication of acute myocardial infarction. The conception of an extensive irreparable myocardial injury underlying the cardiogenic shock has changed especially with the results of the SHOCK study. In addition to the infarction injury, an acute inflammatory reaction, neurohumoral activation as well as improving myocardial stunning influence the development of shock. Mortality is high at the initial stage, whereas subsequent prognosis is equivalent to that seen in other infarction patients. Essential therapy consists in a prompt revascularization of the infarcted area and optimization of hemodynamics, if necessary by applying mechanical supportive therapies.
心源性休克是急性心肌梗死最常见的致命并发症。尤其是随着SHOCK研究结果的出现，心源性休克所基于的广泛不可修复心肌损伤的概念已经发生了变化。除梗死损伤外，急性炎症反应、神经体液激活以及改善心肌顿抑均影响休克的发展。初始阶段死亡率很高，而后续预后与其他梗死患者相当。基本治疗包括梗死区域的迅速血管重建以及血流动力学的优化，必要时应用机械支持治疗。
