Management of cardiogenic shock

Management of cardiogenic shock Cardiogenic shock may result from decompensated chronic heart failure or it may present acutely. Acute coronary syndromes are the principal cause of cardiogenic shock. Optimal therapy includes both symptomatic and aetiological treatments. Improvement of organ perfusion can be met by using a combination of: (i) vascular filling, in the context of cardiogenic shock of acute onset; (ii) vasoactive drugs (inotropes and/or vasoconstrictors); (iii) and mechanical ventilatory support (invasive or non-invasive mechanical ventilation). Aetiological treatment is paramount, especially coronary artery reperfusion in the context of acute coronary syndromes. Recent technological progress has led to the development of circulatory support (partial or total), an attractive alternative to heart transplantation in the presence of cardiogenic shock refractory to conventional management.