A case report of an unusual complication of Amanita phalloides poisoning: Development of cardiogenic shock and its successful treatment with intra-aortic balloon counterpulsation

Backgrounds. Intra-aortic balloon counterpulsation is increasingly used in acute myocardial infarction complicated by cardiogenic shock. The aim of this study was to explore the preference, effect, and prognosis of intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock patients. Methods. Data of acute myocardial infarction complicated by cardiogenic shock patients at the Fourth Medical Center of PLA General Hospital were collected retrospectively. A propensity score was calculated with a logistic regression which contained clinically meaningful variables and variables selected by Lasso and then used to match the control group. The cumulative incidence curve and Gray’s test were employed to analyse the effect and prognosis of intra-aortic balloon counterpulsation on mortality. Results. A total of 1962 acute myocardial infarction cases admitted between May 2015 and November 2018 were identified, and 223 cases with acute myocardial infarction complicated by cardiogenic shock were included as the study cohort, which contained 34 cases that received IABP and 189 cases that did not receive IABP. Patients with higher alanine aminotransferase ( OR = 1.93 , 95% CI 1.29-2.98), higher triglyceride ( OR = 3.71 , 95% CI 1.87-7.95), and higher blood glucose ( OR = 1.08 , 95% CI 0.99-1.18) had a higher probability of receiving intra-aortic balloon counterpulsation. In the propensity score matching analysis, 34 cases received intra-aortic balloon counterpulsation and 102 matched controls were included in the comparison. By comparing the cumulative incidence of in-hospital mortality, there was no statistically significant difference between the intra-aortic balloon counterpulsation group and matched control group ( P = 0.454 ). Conclusion. The use of intra-aortic balloon counterpulsation may not improve the prognosis of the acute myocardial infarction complicated by cardiogenic shock patients.

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Intra-Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Medicina ◽

10.3390/medicina47040030 ◽

2011 ◽

Vol 47 (4) ◽

pp. 30

Author(s):

Andrius Macas ◽

Tomas Bukauskas ◽

Ilona Šuškevičienė ◽

Giedrė Bakšytė ◽

Linas Pieteris ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiogenic Shock ◽

Aortic Wall ◽

High Risk Patient ◽

High Rate ◽

Cardiac Conduction ◽

Cardiac Complications ◽

Intra Aortic Balloon Counterpulsation ◽

Balloon Counterpulsation

Acute myocardial infarction complicated by cardiogenic shock is one of the main reasons of death in severely ill patients. One of the main indications for intra-aortic balloon counterpulsation is acute myocardial infarction complicated by cardiogenic shock. Aortic counterpulsation is associated with the risk of several important complications: bleeding, thrombosis, thrombocytopenia, limb ischemia, and aortic wall damage. The analysis of complications is necessary to better understand the course of myocardial infarction using aortic counterpulsation and to reduce the risk of complications. The aim of the study was to analyze the course of acute myocardial infarction complicated by cardiogenic shock in patients managed by intra-aortic balloon counterpulsation as well as to determine intra-aortic balloon counterpulsation-related complications. Material and Methods. The course of acute myocardial infarction complicated by cardiogenic shock in patients with aortic counterpulsation was analyzed. Patients were recruited from the Cardiology Intensive Care Unit, Department of Cardiology, Lithuanian University of Health Sciences, during the period of 2004–2010. The study comprised 73 patients: 30 women (41.1%) and 43 men (58.9%). Results. Atrial fibrillation and asystolia were the most common cardiac complications during counterpulsation. Atrioventricular block was the predominant disorder of cardiac conduction system; acute renal failure was the most common noncardiac complication. Complications such as major bleeding, infection, aortic wall damage, or amputations were not documented in our study. Successful percutaneous coronary intervention was associated with fewer complications and reduced mortality rate. Conclusions. Aortic counterpulsation may be successfully employed providing significant hemodynamic support with rare major complications in a high-risk patient population. A unique finding of this study is a high rate of successful applications of aortic counterpulsation.

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