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Mechanical Circulatory Support

  • Daniel H. Katz
  • Marwa A. SabeEmail author
Chapter
First Online:
Part of the Contemporary Cardiology book series (CONCARD)

Abstract

In other chapters, there are detailed discussions of acute decompensated heart failure (Chap.  19) and shock (Chap.  21). Cardiogenic shock (CS) represents a state in which cardiac dysfunction is either wholly or partially responsible for an inadequate level of cardiac output to support end-organ function. CS is an especially dangerous state, with in-hospital mortality as high as 27–51% (van Diepen et al., Circulation. 136:e232–68, 2017). Therefore, interventions that promptly reverse the pathophysiologic process are critical. While CS can result from a variety of etiologies – acute myocardial infarction (AMI), acute valvular regurgitation, decompensated heart failure, ventricular tachycardic storm, or myocarditis, to name just a few – once the insult triggers primary dysfunction, the nature of CS is a downward spiral of consequences ultimately resulting in multi-organ failure and death. Even if myocardial ischemia is not the primary cause of cardiac dysfunction, a drop in cardiac output and coronary perfusion pressure during CS nonetheless leads to ischemia and further systolic and diastolic dysfunction, both of which precipitate a feedback loop of progressive dysfunction. This chapter focuses on the use of mechanical circulatory support (MCS) to intervene in the early stages of this cycle.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Beth Israel Deaconess Medical CenterBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA

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