Potential Strategies for Reducing Mortality and Morbidity in Acute Ischemic Cardiogenic Shock

Authors

Richard Smalling, Memorial Hermann Hospital; The University of Texas Health Science Center at HoustonFollow
James McCarthy, Memorial Hermann HospitalFollow
Tim Henry, The Christ Hospital Health NetworkFollow
Ali Denktas, Baylor College of Medicine, Veterans Administration HospitalFollow

Abstract

Cardiogenic shock is predominantly caused by acute ischemic myocardial injury. Despite advancements in reperfusion strategies, outcomes remain poor, with the duration of ischemia before reperfusion playing a crucial role in the development of irreversible damage. This review synthesizes insights from animal models and human studies, highlighting the limited myocardial salvage beyond 90 minutes of ischemia. In light of the high mortality rates associated with cardiogenic shock, this review proposes re-evaluating pre-hospital fibrinolysis, exploring left ventricular unloading strategies before reperfusion, and assessing the potential role of endothelin antagonists. These approaches aim to improve outcomes in this high-risk population.

Recommended Citation

Smalling, Richard; McCarthy, James; Henry, Tim; and Denktas, Ali (2025) "Potential Strategies for Reducing Mortality and Morbidity in Acute Ischemic Cardiogenic Shock," Journal of Shock and Hemodynamics: Vol. 2(2) :e2025222 DOI: https://doi.org/10.58464/2836-0605.1059

Available at: https://digitalcommons.library.tmc.edu/josh/vol2/iss2/2