Infarktbedingter kardiogener Schock

In patients admitted with acute myocardial infarction, cardiogenic shock remains the most common cause of death. Multidisciplinary care in a specialized center and guideline-compliant treatment of cardiogenic shock are crucial for the survival and prognosis of affected patients. Hemodynamic monitoring and stabilization by volume expansion, vasopressors and inotropes represent initial steps in the management of patients with cardiogenic shock. Nevertheless, early revascularization of the culprit-lesion is proved to be the most important treatment modality. Although the use of active mechanical circulatory support appears to be a promising therapeutic concept to improve clinical outcome in patients with infarct-related cardiogenic shock, in the few previous randomized trials mechanical circulatory support failed to show beneficial effects on short-term and long-term survival.

Die vier Schockformen – Teil 2: kardiogener Schock

ZusammenfassungIm 2. Teil der Schockformen-Serie wird der kardiogene Schock behandelt. Dieser tritt mit 16% prähospital genauso häufig auf wie der hypovolämische Schock und stellt eine prognostisch relevante Komplikation eines akuten kardialen Ereignisses dar 1. Ziel dieses Beitrags ist es, diagnostisches und therapeutisches Vorgehen beim kardiogenen Schock, die pathophysiologischen Grundlagen sowie erforderliche differenzialdiagnostische Überlegungen darzustellen.