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Although emergency cardiac care resources are oriented toward rapid implementation of reperfusion therapy with resultant myocardial salvage and improvement in survival, cardiogenic shock remains the leading cause of death among hospitalized patients with acute myocardial infarction (Fig. 1) (1-5).

In the past several years important information has emerged from analysis of patients with cardiogenic shock in thrombolytic therapy trials and through prospective registries of patients with infarction. The role of reperfusion therapy in cardio-genic shock has been further clarified with the publication of the important Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial (6).

This review will discuss the modern concepts and controversies regarding the management of cardiogenic shock occurring as a result of myocardial damage in the setting of acute myocardial infarction.

From: Contemporary Cardiology: Management of Acute Coronary Syndromes, Second Edition Edited by: C. P. Cannon © Humana Press Inc., Totowa, NJ

Introduction Cardiogenic Shock

SPRINT (81-83) GIS5I-I (84-85) GUSTO-I (90-93) SHOCK Reg. (93-9?) NRMI-Z (94-97)

Fig. 1. Hospital mortality rates from trials/registries over the past 2 decades (1-5).

SPRINT (81-83) GIS5I-I (84-85) GUSTO-I (90-93) SHOCK Reg. (93-9?) NRMI-Z (94-97)

Fig. 1. Hospital mortality rates from trials/registries over the past 2 decades (1-5).

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