Department of Cardiology, Freeman Hospital, NE7 7DN Newcastle upon Tyne, UK.
Cardiology Department,Henry Ford Hospital, Detroit, MI 48202, USA.
Rev Cardiovasc Med. 2022 Feb 21;23(2):71. doi: 10.31083/j.rcm2302071.
Patients with acute myocardial infarction (MI) complicated by cardiogenic shock (CS) have poor prognosis. Over the last two decades, there has been some improvement in mortality rates associated with CS. Initial measures to stabilise patients should follow a shock protocol, including therapies such as volume expansion, inotropes/vasopressors, and early coronary revascularisation. The use of mechanical circulatory support (MCS) devices demonstrated better haemodynamic and metabolic profiles for patients with CS. However, these benefits have not been consistently translated into significant reductions in cardiovascular adverse events. This review aims to discuss emerging concepts related to CS including an update on its classification and pathophysiology. The focus is on recent evidence regarding the use of MCS and the timing of initiating in patients with CS.
患有心肌梗死（MI）合并心源性休克（CS）的患者预后较差。在过去的二十年中，CS 相关死亡率有所改善。稳定患者的初始措施应遵循休克方案，包括容量扩充、正性肌力药/血管加压素和早期冠状动脉血运重建等治疗。机械循环支持（MCS）装置的使用为 CS 患者提供了更好的血液动力学和代谢特征。然而，这些益处并未一致转化为心血管不良事件的显著减少。本综述旨在讨论 CS 的相关新概念，包括其分类和病理生理学的更新。重点是最近关于 CS 患者使用 MCS 和开始时机的证据。
