ABSTRACT
Most patients who undergo primary percutaneous coronary intervention (PPCI) have a rapid improvement in their haemodynamic state with restoration of flow in the infarct-related coronary artery and resolution of acute ischaemic left ventricular (LV) systolic dysfunction. The incidence of cardiogenic shock following initial treatment of myocardial infarction (MI) has fallen substantially since the widespread availability of PPCI. A detailed assessment is required in any patient with ongoing clinical evidence of cardiogenic shock. Vital signs should be measured continuously. Clinical examination is essential to assess central venous pressure, peripheral perfusion, detect important heart murmurs and signs of pulmonary oedema. Many drugs are given during the initial treatment of acute MI that have the potential to cause harm in patients who are developing cardiogenic shock. An intra-aortic balloon pump (IABP) is the simplest form of percutaneous mechanical circulatory support (MCS) and can be rapidly placed via the femoral artery.
