Ischaemic cardiogenic shock

Recognition of cardiogenic shock in the setting of myocardial ischaemia has important prognostic and therapeutic implications. Mortality remains high in the order of 50%, despite introduction of urgent revascularization. Resuscitative efforts should focus to avoid multi-organ dysfunction with further spiralling instability that commonly is irreversible. To interrupt these processes, timely recognition and restoration of adequate perfusion is mandatory. The therapeutic means to achieve this beyond early revascularization have been widely debated, in particular the extent of pharmacological support and the timing of mechanical support form key components of modern intensive care treatment. Further research on optimal support and patient selection for more advanced therapies is required.