{"title":"Definition, Classification, and Management of Primary Noncardiac Causes of Cardiogenic Shock.","authors":"Tiffany Yuen, Janek M Senaratne","doi":"10.1016/j.cjca.2024.12.014","DOIUrl":null,"url":null,"abstract":"<p><p>Cardiogenic shock (CS) is a complex syndrome, presenting with a critical state of cardiac output insufficient to support end-organ perfusion requirements. Contemporary CS classification recognizes broad categories of primary cardiac etiologies of CS, such as acute myocardial infarction and heart failure. Primary noncardiac etiologies of CS, however, are poorly described in literature and have not been captured by any contemporary classification, leading to challenges in diagnosing and managing these cases. In this review, we propose that primary noncardiac causes of CS be recognized as its own category that builds on the original Shock Academic Research Consortium classification with its own additional modifiers. We present a detailed framework that groups each noncardiac cause by its underlying disease mechanism (vascular, infectious, inflammatory, traumatic, toxic, cancer related, endocrine, metabolic) and review available literature on their respective management strategies. We expect that the ability to classify primary noncardiac causes of CS will help with early identification and targeted management of the primary noncardiac insult, support patients through their shock state, and may lead to improvement of in-hospital CS mortality rates in clinical practice. Moreover, this new framework can further assist clinical trial classifications to properly phenotype CS for clinical research purposes.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cjca.2024.12.014","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Cardiogenic shock (CS) is a complex syndrome, presenting with a critical state of cardiac output insufficient to support end-organ perfusion requirements. Contemporary CS classification recognizes broad categories of primary cardiac etiologies of CS, such as acute myocardial infarction and heart failure. Primary noncardiac etiologies of CS, however, are poorly described in literature and have not been captured by any contemporary classification, leading to challenges in diagnosing and managing these cases. In this review, we propose that primary noncardiac causes of CS be recognized as its own category that builds on the original Shock Academic Research Consortium classification with its own additional modifiers. We present a detailed framework that groups each noncardiac cause by its underlying disease mechanism (vascular, infectious, inflammatory, traumatic, toxic, cancer related, endocrine, metabolic) and review available literature on their respective management strategies. We expect that the ability to classify primary noncardiac causes of CS will help with early identification and targeted management of the primary noncardiac insult, support patients through their shock state, and may lead to improvement of in-hospital CS mortality rates in clinical practice. Moreover, this new framework can further assist clinical trial classifications to properly phenotype CS for clinical research purposes.
期刊介绍:
The Canadian Journal of Cardiology (CJC) is the official journal of the Canadian Cardiovascular Society (CCS). The CJC is a vehicle for the international dissemination of new knowledge in cardiology and cardiovascular science, particularly serving as the major venue for Canadian cardiovascular medicine.