Kapur Navin K, Thayer Katherine L, Zweck Elric
TUFTS MEDICAL CENTER, BOSTON, MASSACHUSETTS.
Methodist Debakey Cardiovasc J. 2020 Jan-Mar;16(1):16-21. doi: 10.14797/mdcj-16-1-16.
Cardiogenic shock in the setting of acute myocardial infarction remains a major cause of morbidity and mortality. In fact, acute myocardial infarction accounts for 81% of patients in cardiogenic shock. Despite advances in pharmacologic and device-based approaches to support patients with cardiogenic shock, no significant improvement in mortality has been observed over the past 20 years, although multiple registries are providing new insight into this complex syndrome. Key elements for optimal treatment include integration of hemodynamic and metabolic data for diagnosis and risk stratification, early evaluation and appropriate initiation of acute mechanical circulatory support devices, and an organized algorithmic approach to decision making.
急性心肌梗死所致的心源性休克仍然是发病和死亡的主要原因。事实上，急性心肌梗死占心源性休克患者的81%。尽管在支持心源性休克患者的药物和器械治疗方法方面取得了进展，但在过去20年中，死亡率并未显著改善，尽管多个登记处正在为这一复杂综合征提供新的见解。最佳治疗的关键要素包括整合血流动力学和代谢数据以进行诊断和风险分层、早期评估并适当启动急性机械循环支持设备，以及采用有组织的算法方法进行决策。
