[Pharmaceutical therapy of infarct-related cardiogenic shock].

Abstract

Acute myocardial infarction complicated by cardiogenic shock (AMI-CS) is a comparably seldom but fatal entity. The definition of cardiogenic shock - unlike e. g. septic shock - is not uniform. Immediate revascularization is central to the patient's prognosis in AMI-CS. Patients who continue to meet the criteria of shock despite revascularization should be hemodynamically phenotyped to allow guidance of personalized subsequent therapy. Antiplatelet medication is the cornerstone for maintaining myocardial (re)perfusion. In hypotension, norepinephrine should be used as the first-line vasopressor, depending on afterload and after compensation for possible hypovolemia. Dobutamine is recommended to increase inotropy, possibly augmented or substituted by calcium sensitizers such as levosimendan. PDE-III (phosphodiesterase enzyme type III)-inhibitors should be used with restraint in myocardial infarction. Dopamine is no longer recommended in Europe. A sasodilator may be an option in highly selected patients with AMI-CS. This review will provide a detailed updated overview on pharmacological treatment modalities and indications in individual patients.

• Authors: Raphael R Bruno, Malte Kelm, Christian Jung
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 147 Issue 18 Pg. 1173-1182 (09 2022) ISSN: 1439-4413 [Electronic] Germany
• Vernacular Title: Medikamentöse Therapie des infarktbedingten kardiogenen Schocks.
• PMID: 36070734 (Publication Type: Journal Article, Review)
• Copyright: Thieme. All rights reserved.

Chemical References

• Pharmaceutical Preparations
• Simendan

Topics

• Humans
• Myocardial Infarction (complications, drug therapy)
• Pharmaceutical Preparations
• Shock, Cardiogenic (drug therapy, etiology)
• Shock, Septic (complications)
• Simendan (therapeutic use)