scholarly journals Multiple organ dysfunction caused by acute myocardial infarction without typical symptom of cardiogenic shock

2014 ◽  
Vol 25 (4) ◽  
pp. 171-178
Author(s):  
Hiroshi Imamura ◽  
Masataka Ozawa ◽  
Ken-ichi Nitta ◽  
Tomomi Iwashita ◽  
Toshio Sato ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Organ Dysfunction ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Typical Symptom

Treatment of Acute Myocardial Infarction with Cardiogenic Shock using Left Ventricular Assist Device

1989 ◽  
Vol 12 (3) ◽  
pp. 175-179 ◽  
Author(s):  
H. Noda ◽  
H. Takano ◽  
Y. Taenaka ◽  
T. Nakatani ◽  
M. Umezu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Multiple Organ ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Assist Device ◽  
Ventricular Assist ◽  
The Third ◽  
Left Ventricular Assist

We have treated ten cardiogenic shock patients after acute myocardial infarction (AMI) with a left ventricular assist device (LVAD). These patients were later divided into three groups: the first group with ventricular septal perforation, the second with aorto-coronary bypass grafting (ACBG) before LVAD implantation and the third group without ACBG. LVAD maintained the systemic circulation in each group, and cardiac function recovered enough to remove LVAD in 70% of the total patients. Two of three patients in the first group were discharged from hospital. Two weaned cases in the second group died of multiple organ failure and one was discharged, and hemorrhagic necrosis was seen in the bypassed area of the myocardium. One patient of the third group could not be weaned from LVAD because of respiratory failure though his heart function began to recover. Another case in the third group underwent bypass grafting after removal of LVAD. However ACBG surgery should be done very carefully because a patient in shock is occasionally intolerant to major surgery. In all groups, the major cause of death was multiple organ failure which was probably caused by the prolonged low output condition prior to LVAD application. In the light of this experience, it appears that LVAD should be applied before irreversible damage occurs to major organs, including the heart itself. To ensure the timely application of LVAD, some way must be found to introduce systematic application of LVAD into the normal course of AMI treatment.

scholarly journals Therapeutic effects of percutaneous coronary intervention on acute myocardial infarction complicated with multiple organ dysfunction syndrome

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Dajun Qian ◽  
Daqiong Zhou ◽  
Huan Liu ◽  
Di Xu
Keyword(s):  
Myocardial Infarction ◽  
Treatment Group ◽  
Drug Treatment ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Coronary Intervention ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Percutaneous Coronary ◽  
Drug Treatment Group

Objective: To evaluate the clinical efficacy of percutaneous coronary intervention (PCI) on patients with acute myocardial infarction (AMI) complicated with multiple organ dysfunction syndrome (MODS). Methods: A total of 216 patients with AMI complicated with MODS enrolled from January 2016 to March 2018 were divided into a PCI group (n=98) and a drug treatment group (n=118). The baseline clinical data, the incidence of each dysfunction organ, the number of dysfunctional organs and the mortality were compared between the two groups. Results: The number of patients with ST-segment elevation AMI in the PCI group was higher than in the drug treatment group, and the rate of patients with non-ST-segment elevation AMI was lower than in the drug treatment group (P<0.05). The use of temporary pacemakers and IABP was similar between the two groups (P>0.05). The recanalization rate in PCI group was much higher than that in the drug treatment group (P<0.05). The two groups had similar incidence of organ dysfunction in the heart, lungs, kidneys, stomach and intestine, etc. and the PCI group had lower organ dysfunction incidence in the liver, brain and hematological system than the drug treatment group (P<0.05). The dysfunction incidence rate of two organs was higher in PCI group than in drug treatment group (P<0.05), the dysfunction incidence rate of 3 organs was similar between the two groups, and the dysfunction incidence rate of three organs or more was significantly lower in PCI group than in drug treatment group (P<0.05). Conclusion: Despite the high risk and high mortality of patients with AMI plus MODS, clinical improvement can still be achieved when effective PCI is performed. doi: https://doi.org/10.12669/pjms.35.6.1162 How to cite this:Qian D, Zhou D, Liu H, Xu D. Therapeutic effects of percutaneous coronary intervention on acute myocardial infarction complicated with multiple organ dysfunction syndrome. Pak J Med Sci. 2019;35(6):1701-1706. doi: https://doi.org/10.12669/pjms.35.6.1162 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Evidence-based Management of Cardiogenic Shock After Acute Myocardial Infarction

2013 ◽  
Vol 8 (2) ◽  
pp. 73 ◽  
Author(s):  
Karl Werdan ◽  
Martin Russ ◽  
Michael Buerke ◽  
Roland Prondzinsky ◽  
Sebastian Dietz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Multiple Organ ◽  
Class I ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Expert Opinions ◽  
Cardiovascular Therapy ◽  
High Level

Guidelines for evidence-based management of patients with cardiogenic shock after acute myocardial infarction focuses on early revascularisation of the occluded coronary artery as well as on support of cardiac failure and improvement of impaired organ perfusion. Also of great importance is effective treatment of shock complications, especially acute respiratory failure and other forms of multiple organ dysfunction syndrome (MODS). Cardiovascular therapy has to be accompanied by best general intensive care of these critically ill patients with high mortality. Most lives can be saved by early revascularisation, and this class I recommendation has a high level of evidence. So far, most of the other guideline recommendations are of low evidence level, in most cases based on expert opinions. Recently, the Intra-aortic Balloon Pump in Cardiogenic Shock II (IABP SHOCK II) trial with 600 patients has shown that adjunctive IABP therapy – for long a class I recommendation – does not reduce 30-day and six-month motality.

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