Cardiogenic shock due to acute coronary syndrome in the cardiology service of Las Tunas
Keywords:
SHOCK, CARDIOGENIC, ACUTE CORONARY SYNDROME, HEART FAILURE, MYOCARDIAL INFARCTION, PATIENT.Abstract
Introduction: cardiogenic shock is the most severe form of acute heart failure and the main cause of death in patients with acute myocardial infarction.
Objective: to characterize patients with cardiogenic shock due to acute coronary syndrome in the cardiology service of Las Tunas in the period October 2017 to June 2021.
Methods: a descriptive and cross-sectional study was carried out with a universe of 325 patients and a sample intentionally formed by 296 patients with the diagnosis of acute heart failure due to acute coronary syndrome. The variables studied were age, sex, personal pathological history, obesity, smoking, associated valvulopathies, heart rate, systolic blood pressure, previous drug use, adverse events, echocardiographic and electrocardiographic variables.
Results: 16,5 % of the patients studied developed cardiogenic shock; age > 60 years (67,3 % group I vs. 80,3 % group II), male sex and history of HT (87,8 %) prevailed. Previous use of ACEI or ARA II showed an inversely proportional association with the presence of cardiogenic shock (61,5 %). Echocardiographically, reduced LVEF (61,2 %), altered E/e' ratio (32,6 %), S-wave velocity <5,4 cm/sec (42,9 %) and elevated SFV (46,9 %) predominated. STEMI (81,6 %) and anterior topography (51,1%) prevailed.
Conclusions: patients with acute coronary syndrome who most frequently progress to cardiogenic shock are those of advanced age, without previous pharmacological treatment, with anterior topography infarctions and reduced left ventricular ejection fraction.
Downloads
References
1. Kapur NK, Thayer KL, Zweck E. Cardiogenic Shock in the Setting of Acute Myocardial Infarction. Methodist Debakey Cardiovasc J [Internet]. 2020[citado 16/05/2021]; 16(1): 16-21. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137623/
2. Rodríguez-Ramos MA, Santos-Medina M. Sudden intra-hospital death after acute myocardial infarction in Cuba in the last three years. Analysis of institutional records. Arch Cardiol Mex [Internet]. 2020[citado 08/05/2021]; 90(3): 341-346. Disponible en: https://www.scielo.org.mx/scielo.php?pid=S1405-99402020000300341&script=sci_abstract&tlng=en
3. Macedo FVB, Ferreira Filho DSG, Nogueira MAA, Silva VRHD, Nascimento BR. Regressão do Supradesnivelamento do Segmento ST como Preditor de Reperfusão no Infarto Agudo do Miocárdio: Uma Incógnita Persistente. Arq Bras Cardiol [Internet]. 2021[citado 08/05/2021]; 117(1):26-27. Disponible en: https://doi.org/10.36660/abc.20210426
4. Cerda J, Bambs C. Variación estacional de las defunciones por infarto agudo del miocardio en Chile. Rev méd Chile [Internet]. 2021[citado 10/05/2021]; 149(5): 665-671. Disponible en: https://doi.org/10.4067/s0034-98872021000500665
5. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2019 [Internet]. Ministerio de Salud Pública. La Habana; 2020 [citado 01/06/2021]. Disponible en: https://files.sld.cu/bvscuba/files/2020/05/Anuario-Electr%C3%B3nico-Espa%C3%B1ol-2019-ed-2020.pdf
6. Favarato D, Benvenuti LA. Case 1/2020 - A 56 Year-Old Woman Developed Heart Failure after a Presumed Diagnosis of Acute Myocardial Infarction and Mitral Valve Regurgitation with Rupture of Chordae Tendineae. Arq Bras Cardiol [Internet]. 2020[citado 10/05/2021]; 114(4 Suppl 1):47-56. Disponible en: https://doi.org/10.36660/abc.20200024
7. Vahdatpour C, Collins D, Goldberg S. Cardiogenic Shock. J Am Heart Assoc [Internet]. 2019[citado 10/05/2021]; 8(8): e011991. Disponible en: https://doi.org/10.1161/JAHA.119.011991
8. Tehrani BN, Truesdell AG, Psotka MA, et al. A Standardized and Comprehensive Approach to the Management of Cardiogenic Shock. JACC Heart Fail [Internet]. 2020[citado 10/05/2021]; 8(11): 879-891. Disponible en: https://doi.org/10.1016/j.jchf.2020.09.005
9. Tewelde SZ, Liu SS, Winters ME. Cardiogenic Shock. Cardiol Clinics [Internet]. 2018[citado 16/05/2021]; 36(1): 53-61. Disponible en: https://doi.org/10.1016/j.ccl.2017.08.009
10. Shah AH, Puri R, Kalra A. Management of cardiogenic shock complicating acute myocardial infarction: A review. Clin Cardiol [Internet]. 2019[citado 16/05/2021]; 42(4): 484-493. Disponible en: https://doi.org/10.1002/clc.23168
11. Samsky MD, Morrow DA, Proudfoot AG, Hochman JS, Thiele H, Rao SV. Cardiogenic Shock After Acute Myocardial Infarction. JAMA [Internet]. 2021[citado 16/05/2021]; 326(18):1840-1850. Disponible en: https://doi.org/10.1001/jama.2021.18323
12. Brener MI, Rosenblum HR, Burkhoff D. Pathophysiology and Advanced Hemodynamic Assessment of Cardiogenic Shock. Methodist Debakey Cardiovasc J [Internet]. 2020[citado 16/05/2021]; 16(1): 7-15. Disponible en: https://doi.org/10.14797/mdcj-16-1-7
13. Furer A, Wessler J, Burkhoff D. Hemodynamics of Cardiogenic Shock. Interv Cardiol Clin [Internet]. 2017[citado 20/05/2021]; 6(3): 359-371. Disponible en: https://doi.org/10.1016/j.iccl.2017.03.006
14. Thiele H, Ohman EM, de Waha-Thiele S, Zeymer U, Desch S. Management of cardiogenic shock complicating myocardial infarction: an update 2019. Eur Heart J [Internet]. 2019[citado 20/05/2021]; 40(32): 2671-2683. Disponible en: https://doi.org/10.1093/eurheartj/ehz363
15. Kim JH, Sunkara A, Varnado S. Management of Cardiogenic Shock in a Cardiac Intensive Care Unit. Methodist Debakey Cardiovasc J [Internet]. 2020[citado 20/05/2021]; 16(1): 36-42. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32280416/
16. DesJardin JT, Teerlink JR. Inotropic therapies in heart failure and cardiogenic shock: an educational review. Eur Heart J Acute Cardiovasc Care [Internet]. 2021[citado 20/05/2021]; 10(6): 676-686. Disponible en: https://academic.oup.com/ehjacc/article/10/6/676/6314552
17. Obradovic D, Freund A, Desch S, Thiele H. Infarktbedingter kardiogener Schock. Dtsch Med Wochenschr [Internet]. 2020[citado 20/05/2021]; 145(9): 624-632. Disponible en: https://doi.org/10.1055/a-1106-3325
18. Bhimaraj A. The Scourge of Cardiogenic Shock. Methodist Debakey Cardiovasc J [Internet]. 2020[citado 20/05/2021]; 16(1): 5-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32280411/
19. Werdan K, Ferrari MW, Prondzinsky R, Ruß M. Infarktbedingter kardiogener Schock. Herz [Internet]. 2022[citado 20/05/2021]; 47(1): 85-100. Disponible en: https://doi.org/10.1007/s00059-021-05088-1
20. Pepe M, Bortone AS, Giordano A, et al. Cardiogenic Shock Following Acute Myocardial Infarction: What's New? Shock [Internet]. 2020[citado 20/05/2021]; 53(4): 391-399. Disponible en: https://doi.org/10.1097/SHK.0000000000001377
Downloads
Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms: Authors will retain their copyrights and grant the journal the right of first publication of their work, which will be publication of their work, which will be simultaneously subject to the Creative Commons Attribution License (CC-BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g.: deposit it in an institutional telematic archive or publish it in a volume). Likewise, and according to the recommendations of the Medical Sciences Editorial (ECIMED), authors must declare in each article their contribution according to the CRediT taxonomy (contributor roles). This taxonomy includes 14 roles, which can be used to represent the tasks typically performed by contributors in scientific academic production. It should be consulted in monograph) whenever initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which may produce interesting exchanges and increase citations of the published work. (See The effect of open access). https://casrai.org/credit/
