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J Med Cases 2020 Jul 29;11(7):207-210. Epub 2020 Jun 29.

Department of Medical and Surgical Specialties, Institute of Cardiology, University of Brescia, Italy.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is mainly responsible for respiratory involvement but cardiac complications are also reported. Nevertheless, potential life-threatening conditions in young people have not been described. A 19-year-old male autistic patient was admitted with fever and cough. Read More

J Artif Organs 2021 May 13. Epub 2021 May 13.

Division of General Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, 77030, USA.

Left ventricular assist devices (LVADs) are increasingly used as destination therapy or as a bridge to future cardiac transplant in patients with end-stage heart failure. Extracorporeal membrane oxygenation (ECMO) can be used to bridge patients in cardiogenic shock or with decompensated heart failure to durable mechanical circulatory support. We assessed outcomes in patients in critical cardiogenic shock (Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS] profile 1) who underwent implantation of a continuous-flow (CF)-LVAD, with or without preoperative ECMO bridging. Read More

Sao Paulo Med J 2021 May 10. Epub 2021 May 10.

MD, PhD. Full Professor, Cardiovascular Surgery Division, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR; and Cardiovascular Surgeon, Hospital Sírio Libanês (HSL), São Paulo (SP), Brazil.

Context: Heart failure in Brazil is a major public health problem and, even with advances in treatment, it still presents high morbidity and mortality. As a treatment option, mechanical circulatory assist devices (MCADs) have greatly increased in importance over the last decade.

Case Report: This report concerns a case of refractory cardiogenic shock due to acute myocarditis in a 35-year-old puerperal female patient who presented with retrosternal pain, fatigue and dyspnea. Read More

J Cardiovasc Transl Res 2021 May 11. Epub 2021 May 11.

Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

The aim was to translationally compare a pharmacologic strategy versus treatment with the Impella RP in profound RV cardiogenic shock (CS). The pigs were allocated to either vasoactive therapy with norepinephrine (0.10 μg/kg/min) for the first 30 min, supplemented by an infusion of milrinone (0. Read More

Acta Cardiol Sin 2021 May;37(3):312-317

Koc University, School of Medicine.

Sci Rep 2021 05 11;11(1):9959. Epub 2021 May 11.

Center of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, 5 Jingyuan Road, Beijing, 100043, China.

Coronavirus disease 2019 (COVID-19) is a global pandemic impacting nearly 170 countries/regions and millions of patients worldwide. Patients with acute myocardial infarction (AMI) still need to be treated at percutaneous coronary intervention (PCI) centers with relevant safety measures. This retrospective study was conducted to assess the therapeutic outcomes of PCI performed under the safety measures and normal conditions. Read More

Am J Emerg Med 2021 Apr 26. Epub 2021 Apr 26.

Coronary Intensive Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, México City, Mexico.

Prosthetic valve thrombosis (PVT) is considered an exceptionally rare condition, often associated with pro-thrombotic factors or suboptimal anticoagulant therapy. Guidelines recommend emergent surgery for patients with left heart valve prosthetic thrombosis who present in cardiogenic shock, and systemic thrombolysis is reserved in scenarios where surgery is not immediately available. However, several factors may affect surgical prognosis and are overlooked by current recommendations. Read More

Am J Cardiol 2021 May 7. Epub 2021 May 7.

Division of Cardiology, Department of Medicine, Henry Ford Health System, Detroit, Michigan.

Eur J Cardiothorac Surg 2021 May 9. Epub 2021 May 9.

Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA.

Objectives: Obesity may complicate the peripheral cannulation and delivery of veno-arterial extracorporeal life support (ECLS). With rising global body mass indices (BMI), obesity is becoming increasingly prevalent in severe cardiogenic shock yet its impact on outcomes is not well described. This study sought to examine the relationship between BMI and veno-arterial ECLS outcomes to better inform clinical decision-making. Read More

Indian J Thorac Cardiovasc Surg 2021 Apr 11;37(Suppl 2):319-326. Epub 2020 Feb 11.

Department of Cardiothoracic Surgery, National Heart Centre Singapore, 5 Hospital drive, Singapore, 169609 Singapore.

Purpose: The aim of this review is to discuss the role of extracorporeal membrane oxygenation (ECMO) in cardiogenic shock and its use to bridge patients to heart transplantation.

Methods And Results: Consideration of published literature reveals indications for ECMO in cardiogenic shock and tools for patient selection, adequate evidence of its efficacy, its advantages when compared with other temporary mechanical circulatory support devices and details of its use as a bridge to decision, bridge to recovery, bridge to bridge (durable ventricular assist device) and bridge to heart transplant.

Conclusion: ECMO is invaluable in treating patients with medically refractory profound cardiogenic shock and allows for cardiac recovery or planning for permanent heart replacement treatments. Read More

Curr Opin Crit Care 2021 May 6. Epub 2021 May 6.

Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Purpose Of Review: Cardiogenic shock remains a major cause of mortality today. With recent advancements in invasive mechanical support strategies, reperfusion practice, and a new classification scheme is proposed for cardiogenic shock, an updated review of the latest hemodynamic monitoring techniques is important.

Recent Findings: Multiple recent studies have emerged supporting the use of pulmonary artery catheters in the cardiogenic shock population. Read More

Curr Opin Crit Care 2021 May 6. Epub 2021 May 6.

Department of Cardiovascular Medicine Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota, USA Division of Cardiology, Trillium Health Partners, University of Toronto, Mississauga, Ontario, Canada.

Purpose Of Review: Cardiogenic shock continues to carry a high mortality, and recent randomized trials have not identified novel therapies that improve survival. Early optimization of patients with confirmed or suspected cardiogenic shock is crucial, as patients can quickly transition from a hemodynamic shock state to a treatment-resistant hemometabolic shock state, where accumulated metabolic derangements trigger a self-perpetuating cycle of worsening shock.

Recent Findings: We describe a structured ABCDE approach involving stabilization of the airway, breathing and circulation, followed by damage control and etiologic assessment. Read More

ESC Heart Fail 2021 May 8. Epub 2021 May 8.

Department of Anesthesia and Critical Care, Pontchaillou, University Hospital of Rennes, Rennes, France.

Aims: Knowledge about the impact of epinephrine on the outcome in venoarterial (VA) extracorporeal membrane oxygenation (ECMO) patients is limited, and existing data are conflicting.

Methods And Results: We conducted a retrospective cohort study in a 1500 bed tertiary university hospital. Five hundred and eighty-nine VA-ECMO patients were analysed. Read More

Open Heart 2021 May;8(1)

School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

Objectives: To explore the relationship between emergency medical service (EMS) delay time, overall time to reperfusion and clinical outcome in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).

Methods: This was a retrospective observational study of 2976 patients with STEMI who presented to EMS and underwent PPCI between January 2014 and December 2017. We performed multivariable logistic models to assess the relationship between EMS delay time and 30-day mortality and to identify factors associated with system delay time. Read More

J Card Fail 2021 May;27(5):616-617

Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Medicine, Cardiology Section, VA Boston Healthcare System, Boston, Massachusetts. Electronic address:

J Card Fail 2021 May;27(5):560-567

Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; Division of Cardiology, VA Greater Los Angeles Healthcare System, Los Angeles, California. Electronic address:

Background: Patients admitted with cardiogenic shock (CS) have high mortality rates, readmission rates, and healthcare costs. Palliative care services (PCS) may be underused, and the association with 30-day readmission and other predictive factors is unknown. We studied the frequency, etiologies, and predictors of 30-day readmission in CS admissions with and without PCS in the United States. Read More

Curr Cardiol Rep 2021 May 7;23(6):66. Epub 2021 May 7.

Cardiology Division, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland.

Purpose Of Review: Controversy exists whether beta-blockers should be given before primary percutaneous coronary intervention (PCI) or to defer their administration for up to 24 hours.

Recent Findings: Animal studies, most of them conducted in the 1970s and 1980s, showed evidence that early beta-blocker administration may reduce infarct size. Subsequent human studies had mixed results on infarct size and survival. Read More

G Ital Cardiol (Rome) 2021 May;22(5):404-423

U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania - Fondazione per il Tuo cuore - Heart Care Foundation, Firenze.

The treatment of patients with advanced acute heart failure is still challenging. Intra-aortic balloon pump (IABP) has widely been used in the management of patients with cardiogenic shock. However, according to international guidelines, its routinary use in patients with cardiogenic shock is not recommended. Read More

J Card Surg 2021 May 7. Epub 2021 May 7.

Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany.

Objectives: Peripartum cardiomyopathy (PPCM) is a form of systolic heart failure occurring toward the end of pregnancy or in the period after delivery. Lack of myocardial recovery or therapy-refractory cardiogenic shock are rare complications and left ventricular assist device (LVAD) systems might be used as a life-saving option. The aim of this study was to investigate outcomes of PPCM patients supported with LVAD, registered in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). Read More

Anatol J Cardiol 2021 May;25(5):355-359

Department of Cardiology, Walter Reed National Military Medical Center, Bethesda, MD.

Front Cardiovasc Med 2021 20;8:651496. Epub 2021 Apr 20.

Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN, United States.

Thirty four-year-old male with history of D-transposition of the great arteries (D-TGA) who underwent Mustard operation at 14 months of age presented in cardiogenic shock secondary to severe systemic right ventricular failure. Catheterization revealed significantly increased pulmonary pressures. Due to the patient's inotrope dependence and prohibitive pulmonary hypertension, he underwent implantation of a Heart Ware HVAD® for systemic RV support. Read More

Ann Cardiol Angeiol (Paris) 2021 May 3. Epub 2021 May 3.

Service de réanimation médicale, institut de cardiologie, groupe hospitalier Pitié-Salpêtrière, 75651 Paris cedex 13, France.

Hydrostatic pulmonary edema is a well-known complication of veinoarterial extracorporeal membrane oxygenation (VA-ECMO) caused by increased left ventricle afterload due to reverse blood flow in the aorta. Several techniques are commonly used for left ventricle venting such as intra-aortic balloon pump, Impella® (Abiomed, Danvers, MA), central surgical cannulation or Rahskind atrial septostomy. We reported two cases of hydrostatic pulmonary edema in patients under VA-ECMO for whom it was decided to perform Rashkind technique. Read More

Curr Heart Fail Rep 2021 May 6. Epub 2021 May 6.

Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Purpose Of Review: Cardiogenic shock represents a very challenging patient population due to the undifferentiated pathologies presenting as cardiogenic shock, difficult decision-making, prognostication, and ever-expanding support options. The role of cardiac surgeons on this team is evolving.

Recent Findings: The implementation of a shock team is associated with improved outcomes in patients with cardiogenic shock. Read More

Cureus 2021 Apr 1;13(4):e14250. Epub 2021 Apr 1.

Department of Cardiology, McLaren Health Care, Flint/Michigan State University, Flint, USA.

Acute myocarditis is commonly caused by viral infections resulting from viruses such as adenovirus, enteroviruses, and, rarely, coronavirus. It presents with nonspecific symptoms like chest pain, dyspnea, palpitation, or arrhythmias and can progress to dilated cardiomyopathy or heart failure. Fulminant myocarditis is a potentially life-threatening form of the condition and presents as acute, severe heart failure with cardiogenic shock. Read More

Pediatr Crit Care Med 2021 May 7. Epub 2021 May 7.

Department of Pediatric Cardiology and Congenital Cardiac Surgery, University Hospital, Nantes, France. Department of Anesthesiology, University Hospital, Nantes, France. Department of Pediatrics, University Hospital, Rennes, France. Department of Pediatrics, Pediatric Intensive Care Unit, University Hospital, Nantes, France. Department of Pediatrics, University Hospital, Nantes, France. Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre of Research in Epidemiology and StatisticS (CRESS), University of Paris, Paris, France. Department of Pediatrics, Neonatal Intensive Care Unit, University Hospital, Rennes, France. Neonatal and Pediatric Intensive Care Unit, University Hospital, Brest, France. Department of Pediatrics, Neonatal Intensive Care Unit, University Hospital, Nantes, France. Department of Pediatrics, Pediatric Intensive Care Unit, University Hospital, Rennes, France.

Objectives: To describe the frequency and outcomes on the use of extracorporeal membrane oxygenation among critically ill neonates and children within a structured pediatric critical care network in the West of France. To assess the optimality of decision-making process for patients primarily admitted in nonextracorporeal membrane oxygenation centers.

Design: Observational prospective population-based study from January 2015 to December 2019. Read More

Postgrad Med 2021 May 4. Epub 2021 May 4.

The Second School of Clinical Medicine, Southern Medical University, Department of Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China.

Objective: This study aims to develop a nomogram model to predict the survival of refractory cardiogenic shock (RCS) patients that received veno-arterial extracorporeal membrane oxygenation (VA-ECMO).

Methods: A total of 235 and 209 RCS patients were supported with VA-ECMO from January 2018 to December 2019 in Guangdong Provincial People's Hospital, and from January 2020 to December 2020 in four third-grade and class-A hospitals were a development cohort (DC) and validation cohort (VC), respectively. Finally, 137 and 98 patients were included in the DC and VC. Read More

Clin Res Cardiol 2021 May 4. Epub 2021 May 4.

Department of Cardiology and Angiology I (Heart Center Freiburg-Bad Krozingen), Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany.

Background: Patients with cardiogenic shock or cardiac arrest undergoing venoarterial extracorporeal membrane oxygenation (V-A ECMO) frequently present with blood glucose levels out of normal range. The clinical relevance of such findings in the context of V-A ECMO is unknown. We therefore investigated the prognostic relevance of blood glucose at time of cannulation for V-A ECMO. Read More

Cardiovasc Revasc Med 2021 Apr 30. Epub 2021 Apr 30.

Section of Interventional Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States of America. Electronic address:

Background: There are limited data on influence of body mass index (BMI) on outcomes of acute myocardial infarction-cardiogenic shock (AMI-CS).

Methods: Adult AMI-CS admissions from 2008 to 2017 were identified from the National Inpatient Sample and stratified by BMI into underweight (<19.9 kg/m), normal-BMI (19. Read More

Platelets 2021 May 3:1-10. Epub 2021 May 3.

Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.

While previous reports showed ADP-induced platelet reactivity to be an independent predictor of bleeding after PCI in stable patients, this has never been investigated in patients with cardiogenic shock. The association of bleeding events with respect to ADP-induced platelet aggregation was investigated in patients undergoing primary PCI for acute myocardial infarction complicated by cardiogenic shock and with available on-treatment ADP-induced platelet aggregation measurements. Out of 233 patients, 74 suffered from a severe BARC3 or higher bleed. Read More

J Card Surg 2021 May 3. Epub 2021 May 3.

Department of Cardiovascular Surgery, Uskudar University School of Medicine, Istanbul, Turkey.

Currently, the only widely accepted indication for interventional treatment in cases of pulmonary embolism is hemodynamic instability or cardiogenic shock. However, the presence of a right-heart thrombus along with a pulmonary embolism is a poor prognostic indicator, and catheter directed thrombolysis with use of thrombolytic agents should also be considered in this circumstance. Optimal management of right heart thrombus and high-risk pulmonary embolism is still uncertain. Read More