Crispino Simone Pasquale, Segreti Andrea, Nafisio Vincenzo, Ciancio Martina, Cavallari Ilaria, Giannone Sara, Melfi Rosetta, Ussia Gian Paolo, Grigioni Francesco
Department of Cardiovascular Sciences, Fondazione Policlinico Campus Bio-Medico di Roma, 00128 Rome, Italy.
Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy.
Discov Med. 2025 Feb;37(193):222-243. doi: 10.24976/Discov.Med.202537193.19.
Cardiogenic shock (CS) is a critical condition marked by end-organ hypoperfusion and sustained hypotension, necessitating the use of inotropic or vasoactive agents for hemodynamic support. It is the leading cause of mortality in patients with acute myocardial infarction (AMI), exhibiting in-hospital mortality rates of 40% to 50% despite advances in treatment. Treatment strategies aim to restore hemodynamic stability and address the underlying cause through pharmacological agents and mechanical circulatory support devices. However, the persistently high mortality rates underline the challenges of a timely diagnosis, the limitations of current treatments, and the lack of a standardized multidisciplinary network of care. This review critically examines the existing literature on CS management, focusing on the efficacy, safety, and practical application of pharmacological interventions. By synthesizing evidence from recent studies, clinical guidelines, and expert consensus, our objective is to provide a useful, comprehensive, evidence-based framework to guide clinicians in the use of pharmacologic therapies tailored to the diverse presentations and stages of CS.
心源性休克（CS）是一种危急状况，其特征为终末器官灌注不足和持续性低血压，需要使用正性肌力药物或血管活性药物进行血流动力学支持。它是急性心肌梗死（AMI）患者死亡的主要原因，尽管治疗取得了进展，但住院死亡率仍高达40%至50%。治疗策略旨在通过药物和机械循环支持装置恢复血流动力学稳定性并解决潜在病因。然而，持续的高死亡率凸显了及时诊断的挑战、当前治疗的局限性以及缺乏标准化多学科护理网络的问题。本综述批判性地审视了关于CS管理的现有文献，重点关注药物干预的疗效、安全性和实际应用。通过综合近期研究、临床指南和专家共识的证据，我们的目标是提供一个有用的、全面的、基于证据的框架，以指导临床医生使用针对CS不同表现和阶段量身定制的药物治疗。
