[Cardiogenic shock-- new therapeutic strategies]. / Kardiogent sjokk--nye behandlingsmuligheter.
Tidsskr Nor Laegeforen
; 125(10): 1318-21, 2005 May 19.
Article
en Nor
| MEDLINE
| ID: mdl-15909001
ABSTRACT
BACKGROUND:
Cardiogenic shock is a condition associated with high mortality. The evidence base for choice of treatment is insufficient, but new therapeutic options and new understanding have lead to some improvement in the prognosis. A new class of heart failure medication is now approved in Norway (calcium sensitizers).METHODS:
We present a case history that illustrates new options in the treatment of cardiogenic shock complicating acute myocardial infarction. We have searched available literature and give a review of the treatment of cardiogenic shock with special emphasis on the role of inotropic drug therapy. RESULTS ANDINTERPRETATION:
A 46-year-old man with cardiogenic shock complicating myocardial infarction because of occlusion of the left-main coronary artery was treated with acute revascularization, intra-aortic balloon counterpulsation (IABP) and levosimendan. Early revascularization is a key factor in the treatment of cardiogenic shock; rapid transfer of patients to a revascularization centre is recommended. IABP should be considered after successful revascularization because of post-ischaemic dysfunction that persists despite restoration of epicardial blood flow. Beta-adrenergic stimulation of the heart should, if possible, be avoided, because of increased myocardial oxygen requirement, calcium overload of the cardiomyocytes, and increased mortality. Drug therapy using calcium sensitizers is promising, but more controlled clinical trials are needed.
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Banco de datos:
MEDLINE
Asunto principal:
Choque Cardiogénico
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
Límite:
Humans
/
Male
/
Middle aged
Idioma:
Nor
Revista:
Tidsskr Nor Laegeforen
Año:
2005
Tipo del documento:
Article