Cardiogenic Shock

Cardiogenic shock is characterized by depression of cardiac function that leads to low blood pressure, coronary ischemia, and further decreased cardiac contractility resulting in tissue hypoxemia. The condition is associated with high early mortality, approaching 50%, which is largely influenced by the underlying etiologic factors. In infarct-related cardiogenic shock, rapid restoration of coronary blood flow substantially reduces mortality. Mechanical circulatory support devices offer hemodynamic stabilization and improved outcomes in carefully selected patients, although optimal patient selection and timing of initiation of mechanical circulatory support remain areas of active investigation. Although there have been advances in coronary revascularization techniques and mechanical circulatory support devices, overall survival in cardiogenic shock has improved only modestly. Therefore, future research should focus on refining treatment algorithms, optimizing device use, and developing new strategies to address the high mortality associated with cardiogenic shock.