University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Cardiac surgery


Hitoshi Hirose, MD


Case Study: Inferior Myocardial Infarction Resulting in Cardiogenic Shock Requiring Multimodal Mechanical Support

Short Title: Multimodal Mechanical Support Cardiogenic Shock

Key words: cardiogenic shock, mechanical, ECMO, RVAD


Introduction: Cardiogenic Shock initiatives throughout the country have come to the forefront of tertiary care centers. Cardiogenic shock presents in different ways; however, a post myocardial infarction hospital course is a common pathway yet results in nearly a 40% mortality rate. The course of this case study is an outlier in the setting of having a total of four different mechanical circulatory support devices placed ensuing survival.

Case Presentation: 61-year-old male with end-stage-renal-disease presented to the emergency department with an acute inferior wall myocardial infarction. He underwent revascularization; however, he had a complicated hospital course that required the utilization of an intra-aortic balloon pump, veno-arterial ECMO, and percutaneous left and right ventricular assist devices. He survived his course and was discharged.

Discussion: The necessity of each of these devices is important to explore and understand because of their individual indications and how they impact patient survival.


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