¿Cómo abordar y tratar el choque cardiogénico? Actualización y perspectivas sobre el tratamiento farmacológico y mecánico

Cardiogenic shock refers to the reduction in cardiac output caused by myocardial dysfunction, which results in biochemical and clinical manifestations of hypoperfusion. It is mostly due to acute coronary syndromes and less frequently to heart failure. Cardiogenic shock is the most critical state in cardiovascular patients, making timely recognition essential for initiating appropriate treatment. This involves identifying three phases of treatment: rescue, optimization, and weaning off support. The current treatment paradigm involves unloading the left ventricle and providing hemodynamic support, either through medications or ventricular or circulatory assist devices. However, none of these therapies have demonstrated short-term benefits in outcomes. Despite advancements in cardiovascular disease treatment, cardiogenic shock remains highly lethal, so understanding its pathophysiology and current therapeutic options is vital.