Pharmacologic therapies for acute cardiogenic shock

Jose Nativi-Nicolau, Craig H Selzman, James C Fang, Josef Stehlik
Current Opinion in Cardiology 2014, 29 (3): 250-7

PURPOSE OF REVIEW: The natural history of cardiogenic shock has improved significantly with the utilization of revascularization and mechanical circulatory support. Despite the interest in identifying new pharmacological agents, the medical therapy to restore perfusion is limited by their side-effects and no solid evidence about improving outcomes. In this article, we review the current pharmacological agents utilized during cardiogenic shock.

RECENT FINDINGS: Inotropes and vasopressors are widely used to improve hemodynamics acutely; however, reliable information regarding comparative efficacy of individual agents is lacking. A subanalysis of a prospective randomized trial suggested that norepinephrine may be preferred over dopamine in patients with cardiogenic shock. Levosimendan is a new inotrope with calcium sensitization properties that improves acute hemodynamics, but with uncertain effects in mortality. Diuretics are used to decongest patients; however, mortality data are not available. Inhibition of inflammation during cardiogenic shock seems to be a potential therapeutic target; however, initial clinical studies in this area have not shown benefit.

SUMMARY: The current pharmacological treatment for cardiogenic shock includes inotropes, vasopressors and diuretics. The information about comparative effective outcomes is limited and their use should be limited as a temporary measure as a bridge to recovery, mechanical circulatory support or heart transplantation.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"