Der kardiogene Schock (CS) ist keine singuläre Erkrankung, sondern ein komplexes Syndrom.
Nur für wenige Therapien ist bewiesen, dass sie die Prognose verbessern: Dies sind
seit über 20 Jahren die frühzeitige Revaskularisation bei infarktbedingtem CS und
seit diesem Jahr der Einsatz perkutaner linksventrikulärer Unterstützungssysteme bei
ausgewählten Patienten [1]
[2]
[3]. Somit bleiben viele Fragen zur Therapie offen, wie dieser Beitrag zeigt.
Abstract
Cardiogenic shock is not a singular disease but rather a complex syndrome – characterized
by systemic hypoperfusion, elevated intracardiac pressures, and insufficient cardiac
output due to various possible underlying causes, leading to an acute, life-threatening,
and critical condition.
Significant advancements have been made in recent years in understanding the epidemiology,
clinical course, phenotyping, hemodynamics, and the standardized classification of
disease severity. However, progress in therapeutic interventions aimed at improving
prognosis has been comparatively limited, with only a few therapies demonstrating
significant evidence in randomized controlled trials. Among these, early revascularization
in infarct-related cardiogenic shock (Acute Myocardial Infarction with Cardiogenic
Shock – AMICS) has remained a key therapy for more than 20 years, and more recently,
the use of percutaneous left ventricular assist devices in selected patients.
Many questions remain unanswered, including the optimal pharmacotherapeutic regimen,
the role of other mechanical support systems, the management of secondary organ dysfunction,
and the best approach to supportive care.
Schlüsselwörter
kardiogener Schock - akute Herzinsuffizienz - Intensivmedizin - Kardiologie
Keywords
cardiogenic shock - acute heart failure - critical care - cardiology
