Cardiogenic Shock and Mechanical Circulatory Support

  • Stephen P. HooleEmail author
  • Alain Vuylsteke


Cardiogenic shock (CS) is sustained hypotension with inadequate tissue perfusion in spite of adequate left ventricular filling pressure. This is manifested by tissue hypoperfusion and organ dysfunction. The natural history of cardiogenic shock is a downward spiral of ischemic left ventricular (LV) systolic dysfunction and worsening end-organ perfusion, leading to death. The commonest cause of CS is acute myocardial infarction (MI), complicating approximately 2–3% of acute MI (BCIS database 2014). The prognosis is poor, despite instigating supportive treatment, and the mortality rate is greater than 50%. This chapter will review the treatment of CS including the role of mechanical circulatory support after acute MI and/or for patients requiring high-risk percutaneous coronary intervention.


Cardiogenic shock Intra-aortic balloon pump (IABP) Ventricular assist device (VAD) Extracorporeal cardiac life support (ECLS) Extracorporeal membrane oxygenation (ECMO) Cardiac transplantation 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Royal Papworth HospitalCambridgeUK

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