The classical paradigm of cardiogenic shock is severe impairment of left ventricular, right ventricular, or biventricular contractility resulting in decreased cardiac output and end-organ failure. In patients with preserved ejection fraction, cardiogenic shock results from impaired left ventricular filling leading to decreased cardiac output and end-organ hypoperfusion. Heart failure with preserved ejection fraction (HFpEF) comprises a heterogenous group of myocardial and systemic metabolic derangements. Cardiogenic shock with preserved left ventricular ejection is thought to be less common than with reduced left ventricular ejection fraction, and therapeutic approaches are not well standardized. We aim to review the pathophysiology of cardiogenic shock in HFpEF, define various etiologies that culminate in the HFpEF shock state, and present our algorithmic approach to managing these complex patients.
Brailovsky, Yevgeniy; Rame, J. Eduardo; Le Jemtel, Thierry; and Rajapreyar, Indranee
"Hemodynamics and Kinetics of Heart Failure with Preserved Ejection Fraction Shock,"
Journal of Shock and Hemodynamics: Vol. 1(2)
Available at: https://digitalcommons.library.tmc.edu/josh/vol1/iss2/5