Acute decompensated heart failure presenting with cardiogenic shock is a high-mortality clinical challenge characterised by a critical reduction in cardiac output. When systolic blood pressure falls below 90 mmHg and signs of end-organ hypoperfusion are present, this constitutes a distinct, urgent clinical scenario requiring a specific pharmacological approach.
The defining features of this sub-population are cardiogenic shock, a systolic blood pressure below 90 mmHg, and evidence of end-organ hypoperfusion as a direct consequence of cardiac dysfunction. Hypotension alone does not establish the diagnosis — hypoperfusion of downstream organs must be present alongside it.
Evidence-based guidance identifies intravenous inotropic support as the primary pharmacological strategy in this setting, aimed at restoring systemic perfusion and preserving end-organ function. The full protocol specifies which agents apply and the clinical parameters that govern their use.
DOI: 10.1161/CIR.0000000000001063
Cardiogenic shock is a commonly encountered clinical challenge with a high mortality and is characterized by a critical reduction in cardiac output manifest by end-organ dysfunction.
Hypotension (eg, SBP <90 mm Hg) is the primary clinical manifestation of shock but is not sufficient for the diagnosis.
Additionally, end-organ hypoperfusion should be present as a consequence of cardiac dysfunction.
In patients with cardiogenic shock, intravenous inotropic support should be used to maintain systemic perfusion and preserve end-organ performance.
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