We run out of petrol. Suddenly. Then the engine shuts down. And the car stops. Something similar can also happen to the human organism. Because a reaction of this type can occur when the heart, like other organs, suddenly finds itself lacking fuel. There is a lack of blood and oxygen. And we enter the picture of cardiogenic shock, one of the most pressing emergencies in life. Because the heart suddenly stops pumping blood. And so he finds himself without any nourishment available, with his blood pressure dropping, his kidneys stopping working, his brain “switching off”. In short, a vicious circle that must be addressed quickly.
This was reiterated by the experts present in recent days in Florence on the occasion of the “Knowing and Treating the Heart” conference, dedicated precisely to the importance of the time factor in the prognosis of cardiovascular emergencies. The shock that “arises” from the heart, perhaps due to a heart attack or a sudden, dramatic picture of heart failure which arises equally acutely, in this sense, is a clear example of a “time-dependent” pathology. And it must be recognized and treated as soon as possible. In fact, it is necessary to anticipate the dangerous spiral which, starting from a haemodynamic alteration, leads to reduced cardiac output with consequent lack of blood and oxygen throughout the body which then promotes metabolic problems. Putting their lives at risk.
Injectable gel plus pacemaker, so we will reduce the risk of ventricular fibrillation after a heart attack
by Federico Mereta
Because it matters to act now
“Cardiogenic shock can be defined as a state of inadequate organ perfusion due primarily to cardiac pump dysfunction – he explains Francesco Prati, President of the Center for the Fight Against Heart Attack Foundation. This condition can be linked to different reasons: the most recent epidemiological data show a reduction in the incidence of cardiogenic shock caused by coronary syndrome in favor of cases linked to other causes”. The important thing, in any case, is to try to immediately understand what is happening. Because there can be many causes for the sudden decline in cardiac function.
There is an algorithm, suggested by the European Guidelines, defined by the acronym CHAMPIT (acute coronary syndrome, hypertensive emergency, arrhythmia, mechanical causes, pulmonary embolism, infections, cardiac tamponade) which lists the aspects to take into consideration to guide the initial diagnosis hypothesis. And then we need to start with targeted checks, from the 12-lead electrocardiogram to the ultrasound, blood gas analysis and blood and urine tests. In addition obviously to specific tests. What matters in any case is to remember that even for this condition, as for theheart attackwe need to act quickly.
“Cardiogenic shock represents a time-dependent critical condition that requires a targeted therapeutic planning strategy from the first clinical contact, defining a short period of time as the “golden hour” for the classification and initial management – reports Prati”.
iHEART, here is the heart simulator to treat heart attacks and arrhythmias
by Federico Mereta
Objective, tailor-made therapy
First of all, it is necessary to recognize the cause that “turns off” the heart’s drive. And then we need to move accordingly, perhaps even focusing on technology, with tools that can also take the place of the heart that doesn’t pump. “The therapy of cardiogenic shock is based on two fundamental cornerstones: the treatment of the underlying cause, for example the revascularization myocardial infarction, and support therapy aimed at improving perfusion and oxygenation through the use of vasoactive drugs and mechanical circulation support devices – recalls Prati”.
Unfortunately, therefore, it is difficult to identify therapeutic approaches that are the same for everyone. There are cases in which in addition to drugs it is necessary to focus on assisted ventilation, others in which one can instead rely on devices aimed at helping the heart. In short, a tailor-made treatment is needed. According to experts, in any case, it is important to think in terms of an assistance model. The variety of presentations of cardiogenic shock, the severity and potential causes, and the need for personalized therapies make decisions even more difficult. The answer can come from a multidisciplinary team.
“The introduction of the model”hub-and-spoke“has demonstrated positive effects on the outcomes of treatment in real life – concludes Prati. The “hub” hospital is equipped with a multidisciplinary team made up of an interventional cardiologist, expert in emergency medicine, cardiac surgeon and specialist in advanced heart failure. The hospitals ” spoke” include centers equipped with haemodynamics without the availability of advanced circulation supports or hospitals not equipped with haemodynamics, both referring to the “hub” centre. The answer therefore comes from a specialized team. Remembering that the time factor is fundamental. And it should never be underestimated. The sooner you get treatment, the more hope there is of saving your heart. And a person’s life.
Wearable defibrillator, when needed for those at risk of cardiac arrest
by Federico Mereta
#Cardiogenic #shock #act #quickly
– 2024-03-31 14:47:05
