Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
|Section 7. Cardiovascular Disease >|
Chapter 54. Cardiogenic Shock
Sections: Cardiogenic Shock: Introduction, Pathophysiology, Clinical Features, Diagnosis, Treatment, Disposition and Follow-Up, Practice Guidelines, References.
Topics Discussed: cardiogenic shock.
Excerpt:"Cardiogenic shock is an acute state of decreased cardiac output
resulting in inadequate tissue perfusion despite adequate or excessive
circulating volume. Cardiogenic shock remains the leading cause
of death in patients with acute myocardial infarction (AMI) who
reach the hospital alive. The precise overall incidence of cardiogenic
shock is difficult to ascertain because patients who die before
hospital presentation are not given the diagnosis. However, for
those who reach the hospital alive, the incidence is approximately
6% to 8%, and has remained constant for the past
three decades.13 During the past decade,
a strategy of early revascularization, either by percutaneous coronary
intervention or coronary artery bypass surgery, has proven superior
to initial aggressive medical therapy.46 Despite
these advances, once cardiogenic shock is diagnosed, the mortality
remains high (~50%), with half of the deaths occurring within
the first 48 hours after presentation.79..."
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