Challenges of Critical Cardiac Imaging in Cardiogenic Shock

To the editor of JCCM
I am writing in reference to the article published by Theodora Benedek and Dan Dobreanu in the first issue of JCCM, entitled “Current Concepts and New Trends in the Treatment of Cardiogenic Shock Complicating
Acute Myocardial Infarction”.
Cardiogenic shock (CS) represents a critical and life-threatening condition. Survival of patients with CS depends largely, not only on the appropriateness of the therapeutic measures, but also on the correct identification of the underlying disease [1].
Treatment of this underlying condition represents a key element for the correction of the patho-phyisiological pathways responsible for the development of a CS.
In many cases, CS occurs in association with an acute myocardial infarction, usually large infarcts, located on the anterior ventricular wall [2]. Prompt revascularisation is crucial in these cases, as the re-establishment of coronary flow would immediately improve the haemodynamic status of these critically ill patients. However, in routine clinical practice, the diagnosis of an acute coronary syndrome remains challenging, especially when the physician is faced with a patient who arrives in the emergency room (ER) intubated, after surviving a cardiac arrest of unknown aetiology. [More]