Management of Cardiogenic Shock Complicating Acute Myocardial Infarction

The incidence of cardiogenic shock in community studies has not decreased significantly over time. Despite decreasing mortality rates associated with increasing utilisation of revascularisation, shock remains the leading cause of death for patients hospitalised with acute myocardial infarction (MI). Although shock often develops early after MI onset, it is typically not diagnosed on hospital presentation. Failure to recognise early haemodynamic compromise and the increased early use of hypotension inducing treatments may explain this observation. Recently, a randomised trial has demonstrated that early revascularisation reduces six and 12 month mortality. 2 The current American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend the adoption of an early revascularisation strategy for patients < 75 years of age with cardiogenic shock. In this article, we review the incidence, aetiology, prevention, and recognition of shock, as well as its management.