Cardionerds: A Cardiology Podcast 418. CardioNerds x CSWG – LV Unloading in AMI-Shock with Dr. Navin Kapur, Dr. Shashank Sinha & Dr. Rachna Kataria
May 14, 2025
Dr. Navin Kapur, a leader in cardiogenic shock research, and Dr. Shashank Sinha, an expert in heart failure, join forces to delve into recent advancements in LV unloading for acute myocardial infarction. They discuss a complex case of a woman with a rare coronary anomaly and the challenges faced in managing cardiogenic shock. Highlights include new guidelines, the significance of advanced interventions like ECMO and Impella CP, and the importance of interdisciplinary collaboration in emergency cardiac care.
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DANGER Trial Revolutionizes Shock Care
- The DANGER trial was the first positive randomized controlled trial for cardiogenic shock, focusing on early use of transvalvular pumps in STEMI shock.
- It emphasized specific patient selection and early intervention, changing previous views on routine use of pumps and ECMO.
Complex Case of Cardiogenic Shock
- A 68-year-old woman with an unusual coronary anatomy complicated by STEMI shock showed the complexity of managing cardiogenic shock.
- She required escalation from IABP to VA ECMO and Impella CP after being transferred for advanced care.
Classify Shock Severity Early
- Classify cardiogenic shock severity using frameworks like CSWG's SCAI shock staging to guide management.
- Recognize that vasopressor requirement equals cardiogenic shock and adjust mindset and treatment accordingly.
