Available online 10 June 2022, 108230

Cardiogenic shock is a clinical syndrome of impaired tissue perfusion caused by primary cardiac dysfunction and inadequate cardiac output. It represents one of the most lethal clinical conditions in intensive care medicine with mortality >40%. Management of different clinical presentations of cardiogenic shock includes guidance of cardiac preload, afterload, heart rate and contractility by differential pharmacological modulation of volume, systemic and pulmonary vascular resistance and cardiac output besides reversing the triggering cause. Data from large registries and randomized controlled trials on optimal diagnostic guidance as well as choice of pharmacological agents has accrued significantly in recent years. This state-of-the-art review summarizes the basic concepts of cardiogenic shock, the diagnostic work-up and currently available evidence and guideline recommendations on pharmacological treatment of cardiogenic shock.

Cardiogenic shock

Pharmacological treatment

Heart failure

American Heart Association

Acute myocardial infarction

Acute myocardial infarction related cardiogenic shock

Adenosine monophosphate

Cyclic adenosine monophosphate

Cyclic guanine monophosphate

Global oxygen delivery

European Society of Cardiology

Acute decompensated heart failure related cardiogenic shock

Interagency Registry for Mechanically Assisted Circulatory Support

Inositol trisphosphate

Left ventricular end-diastolic pressure

Mean arterial pressure

Pulmonary artery catheter

Pulmonary capillary wedge pressure

Phosphodiesterase enzyme III

Pulse Contour Cardiac Output

Partial pressure (tension) of oxygen

Pulmonary Vascular Resistance

Renin-Angiotensin-Aldosterone System

Society for Cardiovascular Angiography and Interventions

Systemic inflammatory response syndrome

Systemic vascular resistance

Systemic vascular resistance index

Tumor necrosis factor-α

Global oxygen consumption

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