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A Journal on Heart and Vascular Diseases

Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2012 April;60(2):167-74

language: English

Cardiogenic shock: management of right ventricular infarction shock

Ruiz Bailén M. 1, 2, Ruiz García M. I. 2, Ferrezuelo Mata A. 2, Quirós Barrera R. 2

1 Department of Health Science, Jaén University, Jaén, Spain;
2 Intensive Care Unit, Critical Care and Emergency Department, Medical and Surgical Hospital, Jaén University, Jaén, Spain


Right ventricular infarction is a not uncommon cause of cardiogenic shock, whose frecuency is variable and could be underestimated. Although left ventricular myocardial management is well defined in the right ventricular infarction are few studies with low level of evidence, to establish definitive guidelines. It is assumed that the treatment is similar to that of the left ventricle, although there are some differences. The axis of the therapeutic management, as well as the left ventricle infarction, is based on early myocardial reperfusion, particularly through percutaneous coronary interventionism. Throm-bolysis is an option, especially after an increase in systemic blood pressure using vasoactive drugs such as norepinephrine. The preload optimization by volume administration during resuscitation of shock is useful, but it must be with caution. The use of levosimendan could be potentially beneficial option. On the neurohormonal modulation of systemic inflammatory response produced after the cardiogenic shock (CS), the use of ACE inhibitors and beta-blockers is controversial.

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