Treatment of ST-Elevation Myocardial Infarction Complicated by Cardiogenic Shock

Clinical Scenario

Acute ST-elevation myocardial infarction (STEMI) demands immediate action. When cardiogenic shock develops as a complication, the clinical urgency intensifies and the treatment pathway shifts accordingly.

This Protocol Applies When

The patient has acute ST-elevation myocardial infarction complicated by cardiogenic shock. Early revascularization is recommended in this population, as established by the landmark SHOCK trial.

Treatment Approach (Partial — Full Regimen Behind)

Management in this scenario involves a surgical revascularization strategy when other approaches are not feasible — see the full protocol for the complete, sequenced regimen.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/ehad191

Early revascularization with either PCI or CABG is recommended for patients with AMI complicated by CS, based on the results of the SHOCK (Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock) trial.

Emergency CABG is recommended for ACS-related CS if PCI of the IRA is not feasible/unsuccessful.

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