The five key “ingredients” for improving outcomes in cardiogenic shock complicating acute myocardial infarction

Key Points Cardiogenic shock in the setting of acute myocardial infarction (AMICS) carries high mortality. A systematic, protocol‐driven, approach to AMICS may improve outcomes. The 5 key “ingredients” for the managements of AMICS are: (a) early diagnosis; (b) hemodynamic assessment; (c) culprit‐only coronary revascularization; (d) judicious use of mechanic circulatory support; (e) expert in‐hospital treatment.
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Coronary Artery Disease Source Type: research

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CONCLUSIONS: Short-term survival for patients with STEMI and OHCA undergoing emergent coronary angiography and revascularization with TTM in this contemporary, multicenter registry was high and neurologic outcome was good in more than half of patients. PMID: 31941835 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
We present three cases of 5-FU cardiac toxicity that manifested as myocardial infarction, cardiogenic shock, and ventricular fibrillation. Additionally, we discuss the current literature regarding 5-fluorouracil cardiotoxicity mechanisms as well as management. PMID: 31925673 [PubMed - as supplied by publisher]
Source: Cardiovascular Toxicology - Category: Cardiology Authors: Tags: Cardiovasc Toxicol Source Type: research
Publication date: January 2020Source: Archives of Cardiovascular Diseases Supplements, Volume 12, Issue 1Author(s): C. Bernard, M.C. Morgant, A. Jazayeri, A. Bernard, O. BouchotDuring acute phase of myocardial infarction (MI), the culprite artery must be revascularized quickly with angioplasty. Then, surgery complete the procedure in a second time. If surgery is emergent, resulting death rate is really high; 15 to 20% of patients operated on within the first 48 hours and 4 to 5% for patients operated on after. Various factors influence mortality rate; timing of surgical revascularization and patient's preoperative sta...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Cardiogenic shock (CS) is a catastrophic consequence of ST-elevation myocardial infarction (STEMI). CS has been reported to be associated less often with inferior wall (IWMI) than anterior wall STEMI (AWMI). We queried the National Inpatient Sample databases from January 2010 to September 2015 to identify all patients aged ≥18 years admitted with AWMI or IWMI. Patients with a concomitant diagnosis of CS were then identified. Complex samples multivariable logistic regression models were used to compare the incidence, management, and in-hospital mortality of CS complicating IWMI vs.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
AbstractThe 30-day readmission rates, predictors, and outcomes for acute heart failure (AHF) patients are well published, but data beyond 30  days and the association between readmission-free period (RFP) and in-hospital readmission-related mortality remain unknown. We queried the National Readmission Database to analyze comparative outcomes of AHF. Patients were divided into three groups based on their RFP: group 1 (1–30 days), grou p 2 (31–90 days), and group 3 (91–275 days). AHF cases and clinical variables were identified using ICD-9 codes. The primary outcome was in-hospital morta...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
In this study, benefits of minimized bypass in CABG were evaluated under particular consideration of patient body mass index and surgeon impact. From 2004 to 2014, 5164 patients underwent coronary bypass surgery (CABG). Conventional cardiopulmonary bypass (CCPB) was used in 2376 patients, minimized cardiopulmonary bypass (MCPB) in 2788 cases. Multivariate regression models were used in the entire cohort and in a propensity score-matched subgroup after expert CABG to figure out clinical differences such as mortality, postoperative renal function, and thromboembolic events. Overall mortality was 1.5% (n = 41) i...
Source: Heart and Vessels - Category: Cardiology Source Type: research
Abstract BACKGROUND: Patients presenting with acute coronary syndrome (ACS) from left main (LM) disease are at a high risk for mortality despite recent advancement in devices and techniques during percutaneous coronary interventions (PCI). We aimed to evaluate patient characteristics, clinical presentations, and key clinical characteristics associated with adverse in-hospital outcomes among ACS patients undergoing LM-PCI. METHODS: We retrospectively identified 280 LM-ACS patients (3.7 %) from 7608 ACS patients in the prospective multicenter Japan Cardiovascular Database-Keio Inter-Hospital Cardiovascular Stud...
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
Myocarditis is commonly associated with viruses. However, we present a novel case of a teenager with pneumococcal pneumonia and bacteremia complicated by myocarditis and rhabdomyolysis, presenting with features of acute ST-elevation myocardial infarction and cardiogenic shock. Physicians should be aware that Streptococcus pneumoniae infection, like Group A Streptococcus, can mimic acute myocardial infarction in young males without cardiovascular risk factors.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Instructive Cases Source Type: research
Cardiology MCQ – Classic cardiogenic shock – Answer My Cardiology MCQ books on Amazon “Classic” cardiogenic shock having hypotension with features of hypoperfusion, needing inotropes and mechanical circulatory support comes under Stage — of the 2019 SCAI (Society for Cardiovascular Angiography and Intervention) classification: Correct answer: 3. Stage C The Society for Cardiovascular Angiography and Intervention (SCAI) has classified cardiogenic shock into stages from A through E. Stage A: “At risk” for cardiogenic shock – large myocardial infarction or heart failure, but no...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Conclusion: The main findings of the present study are that baseline lactate is a powerful predictor of 30-day mortality, lactate at 6, 12, and 24 h after admission are predictors of 30-day mortality, and a relative change in lactate is a significant predictor of survival within the first 24 h after instituting intensive care treatment adding information beyond the information from baseline values.
Source: Shock - Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research
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