Leading Expertise in Treating Cardiogenic Shock

Cardiogenic shock is a condition in which the heart is unable to pump enough blood to meet the needs of the body. It most commonly occurs soon after a massive heart attack, but it can also occur after heart surgery or with an acute illness such as cardiomyopathy, which is a weakening of the heart muscle. Occasionally, patients with chronic heart failure will deteriorate to cardiogenic shock.

Patients with cardiogenic shock must be treated promptly in order to restore perfusion, the process of delivering blood to the body’s organs, and prevent further deterioration so that the heart can recover. At Massachusetts General Hospital, mechanical circulatory support devices are used when necessary to either temporarily support the heart as it recovers, or as a bridge to long-term therapies, which may include heart transplantation. Timely intervention with mechanical support in appropriate cardiogenic shock patients has been shown to improve patient outcomes.

Request an Evaluation for Cardiogenic Shock

The Mass General Cardiogenic Shock Team brings together the expertise of cardiologists and cardiac surgeons to rapidly intervene on patients with severe cardiogenic shock. With one phone call, a multidisciplinary team of leading surgical, interventional and medical clinicians quickly gathers information about the patient to recommend the best therapy possible.
 
The Mass General Cardiogenic Shock Team should be contacted for patients with:

  • Sustained hypotension (systolic blood pressure [BP] less than 90 mm Hg lasting more than 30 minutes)
  • Evidence of tissue hypoperfusion: cold periphery (extremities colder than core), oliguria (< 30 mL/h) or both
  • Inadequate left ventricular (LV) filling pressure

We are available 24 hours a day, seven days a week, to assist with the immediate evaluation and management of cardiogenic shock patients. Physicians should call 617-726-2066 to speak with the team member on call.

Advanced Options to Treat Cardiogenic Shock

The Cardiogenic Shock Team utilizes innovative devices to assist a patient’s heart in pumping blood. These include:

  • Impella®: A catheter-based pump is inserted through a patient’s peripheral artery, which can be used without opening a patient’s chest. Devices are available that can support either the right or left side of the heart
  • CentriMag® Ventricular Assist System: A machine located outside the patient’s body facilitates blood flow through tubes placed surgically in a patient’s large arteries and veins that connect to the pumping chamber of the heart. CentriMag can support either the right or left sides of the heart, or both, until it is determined that the patient’s heart will either recover or need further support with a long-term ventricular assist device (VAD)
  • Extracorporeal Membrane Oxygenator Support (ECMO): Patients experiencing cardiogenic shock may also need help with lung support until the heart and lungs recover or a VAD is recommended. When an oxygenator is added to a device containing a pump such as the CentriMag, both the patient’s heart and lungs can be mechanically supported. Because of its ease and success of use, ECMO is often the device of first choice used in cardiogenic shock at Mass General

Mass General has been designated as an ECMO Center of Excellence based on our extensive experience and successful outcomes in a variety of conditions leading to cardiogenic shock.

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