Mechanical versus pharmacologic support for cardiogenic shock.

ABSTRACT

Dynamic left ventricular outflow tract obstruction is a rare cause of cardiogenic shock after an acute myocardial infarction. A case is presented where inotropic support and an intra-aortic balloon pump aggravated the cardiac hemodynamics by this mechanism. The circulatory support provided by Impella 2.5 heart pump, in addition to discontinuation of inotropic support and intra-aortic balloon pump, allowed stabilization and successful percutaneous revascularization.