Journal article
Cardiogenic Shock in Non-Ischemic Cardiomyopathy: Dynamic Mechanical Circulatory Support and Pathophysiology Illustration
Current problems in cardiology, Vol.49(1, Part C), 102126
01/2024
DOI: 10.1016/j.cpcardiol.2023.102126
PMID: 37802166
Abstract
Non-ischemic cardiomyopathy (NICM) is a significant cause of cardiogenic shock (CS). We present a case of a 56-year-old previously healthy man who arrived with vague abdominal symptoms, over two weeks. Subsequently, the patient's condition rapidly deteriorated over 12 hours, leading to cardiogenic shock categorized as Society for Cardiovascular Angiography and Interventions (SCAI) stage D. Echocardiography and right heart catheterization confirmed multi-organ failure secondary to severe cardiac dysfunction.
Mechanical circulatory support was initiated using an Impella CP device 20 hours after admission due to ongoing deterioration. Considering refractory cardiogenic shock and within 24 hours, the patient received combined veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and Impella CP support (ECPElla). With gradual improvement in the patient's clinical status and organ function, successful weaning from VA ECMO to Impella 5.5 was achieved.
Ultimately, the patient underwent a successful orthotopic heart and kidney transplantation, marking a significant milestone in his recovery. The case underscores the importance of promptly identifying and responding to cardiogenic shock through invasive hemodynamic assessment. Collaborative decision-making involving a multidisciplinary team played a crucial role in the initiation, escalation, and eventual weaning of mechanical circulatory support, culminating in the successful bridging to a dual organ transplantation for this patient with CS secondary to NICM.
Details
- Title: Subtitle
- Cardiogenic Shock in Non-Ischemic Cardiomyopathy: Dynamic Mechanical Circulatory Support and Pathophysiology Illustration
- Creators
- Mohammed Mhanna - University of IowaArun Singhal - University of IowaAnthony Panos - University of IowaDennis J. Firchau - University of IowaShareef Mansour - University of IowaNicholas Isom - University of IowaAlexandros Briasoulis - University of IowaErnesto Ruiz Duque - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Current problems in cardiology, Vol.49(1, Part C), 102126
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.cpcardiol.2023.102126
- PMID
- 37802166
- ISSN
- 0146-2806
- eISSN
- 1535-6280
- Grant note
- DOI: 10.13039/100000038, name: U.S. Food and Drug Administration
- Language
- English
- Electronic publication date
- 10/04/2023
- Date published
- 01/2024
- Academic Unit
- Pathology; Cardiovascular Medicine; Cardiothoracic Surgery; Internal Medicine
- Record Identifier
- 9984476559702771
Metrics
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