Management of cardiogenic shock complicating ST-segment elevation myocardial infarction: part 1

Cardiogenic shock associated with ST-segment elevation myocardial infarction (STEMI) is a potentially devastating complication. This type of shock consists of left ventricular dysfunction causing haemodynamic instability and end-organ hypoperfusion resulting in multi-organ dysfunction syndrome. Despite advances in the management of STEMI, especially in the realm of reperfusion strategies, mortality rates remain high. The pathophysiology is complex and multifactorial, resulting in a clinical presentation of hypotension and signs of hypoperfusion. Patient assessment comprises a targeted history and a thorough physical examination to detect signs of decompensation and end-organ hypoperfusion. Upon arrival in hospital, an echocardiograph is essential in the process of identifying a cause.