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Door to Unload: a New Paradigm for the Management of Cardiogenic Shock


Cardiogenic shock (CS) remains the most common cause of in-hospital mortality in the setting of acute myocardial infarction (AMI). Recent data have identified several concerning trends in the field of AMI-CS that include an overall increase in mortality, an increase in patient complexity, minimal use of acute mechanical circulatory support (AMCS) devices with the majority being implanted as a bailout option. In this review, we will discuss recent trends in CS and the rationale for the use of acute mechanical circulatory support pumps early in the clinical treatment of CS.

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Correspondence to Navin K. Kapur.

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Conflict of Interest

Dr. Kapur receives research support from Abiomed, CardiacAssist, and Maquet as well as speaker honoraria/consulting fees from Abiomed, Maquet, and St. Jude. Dr. Esposito has no relevant conflicts of interest.

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This article does not contain studies with human or animal subjects performed by the author.

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This article is part of the Topical Collection on Secondary Prevention and Intervention

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Kapur, N.K., Esposito, M.L. Door to Unload: a New Paradigm for the Management of Cardiogenic Shock. Curr Cardiovasc Risk Rep 10, 41 (2016).

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  • Ventricular unloading
  • Acute mechanical circulatory support
  • Cardiogenic shock
  • Hemodynamics
  • Percutaneous ventricular assist device