| Abstract [eng] |
Cardiogenic shock is a condition caused by acute cardiac insufficiency that leads to hypoperfusion, tissue hypoxia, and multiorgan failure. Even though the survival rate for patients with cardiogenic shock caused by acute myocardial infarction has improved, in-hospital mortality remained high in the last decades. In this paper, 2 cases of patients diagnosed with cardiogenic shock caused by acute myocardial infarction are presented. The first patient was a 74-year-old woman who was transferred to Vilnius university hospital Santaros klinikos in a serious condition suspecting an acute myocardial infarction with an interventricular septum rupture. It was decided to postpone the surgical treatment waiting for the edges of the ruptured septum to scar and reconsider it later. Despite the optimal treatment received during this waiting period, the patient died. The second patient was an 83-year-old woman whose condition was fair upon arrival. Electrocardiogram demonstrated signs of acute myocardial infarction. Coronary angiography and percutaneous coronary intervention were performed consequently. Furthermore, a temporary pacing electrode catheter was placed in the right ventricle. She was released after 13 days of hospitalization continuing her rehabilitation program. Even though there are treatment guidelines for the cardiogenic shock of different etiologies there is a great lack of comprehensive recommendations based on randomized controlled clinical trials. Patients can deteriorate quickly, therefore it is important to have a structured plan of diagnosis and treatment and perform essential steps using the „ABCDE“ principle. After completing a literature review, we suggest a diagnostic and treatment scheme for cardiogenic shock caused by myocardial infarction. |
