Managing the acute cardiac functional crisis: a comprehensive review of cardiogenic shock management strategies

Cardiogenic shock (CS) is a life-threatening condition defined by the heart's inability to adequately pump blood to meet metabolic demands, leading to systemic hypoperfusion and insufficient tissue oxygenation. Despite treatment advancements, CS continues to carry high morbidity and mortality rates, especially when it follows acute myocardial infarction. Various expert groups and scientific societies have proposed recommendations and management pathways, each contributing unique insights yet sometimes overlooking important clinical considerations. This mini-review provides an updated, integrated overview of distinct CS scenarios, including ischaemic, non-ischaemic, and post-cardiotomy categories, and their respective treatment strategies. Additionally, this review explores management approaches that underscore the importance of early detection of inflammatory markers in non-ischaemic CS and targeted therapeutic interventions for each CS subtype. Specifically, the role of pharmacological treatments is examined alongside the relevance and timing of mechanical circulatory support devices. A deeper understanding of the pathophysiology and tailored management pathways for each CS type may enable clinicians to improve interventions and enhance survival and recovery in patients with CS.