Consensus of cardiogenic shock complicating acute myocardial infarction 2025

Abstract

In this document we will focus on CS in its most common cause, acute myocardial infarction. It has high morbidity and mortality. It is characterized by a state of sustained tissue hypoperfusion, without response to initial support measures, characterized by arterial hypotension, tachycardia and signs of peripheral hypoperfusion (oligury, cold extremities and deterioration of sensorium) and systemic and pulmonary venous congestion. In 2019, the North American Society of Angiography and Interventions (SCAI) established Shock stages from “A” to “E”:

Prompt recognition is imperative for patient survival. The urgent opening of the responsible artery constitutes one of the therapeutic pillars of treatment in patients with AMI that complicate with CS. Coronary angioplasty (CTA) was shown to improve the prognosis, although in some specific situations the use of thrombolytics or revascularization through surgery could be considered. The use of ventricular assist devices for patients in stages D to E.