Cardiogenic shock

Extended or complicated myocardial infarction is the most common aetiology of the disease. Cardiogenic shock in the acute phase of MI requires urgent management by angioplasty and it is necessary to systematically look for a mechanical complication (tamponade, mitral insufficiency, septal rupture). Norepinephrine is the vasopressor of choice and dobutamine is the inotrope of choice. In the event of refractory cardiogenic shock, ECMO/ECLS circulatory assistance should be rapidly established and the patient transfer to the referral centre should be assisted by ECMO via a mobile circulatory assistance unit. Care management must be part of a care network linked to a Cardiac Shock Reference Centre.