FRANCIS J. HADDY, M.D., Ph.D., F.A.C.P.
Cardiogenic shock results from a decrease in coronary blood flow that, by lowering the tension of myocardial oxygen and raising the concentration of myocardial depressant metabolites, reduces contractile strength and cardiac output. An effort should, therefore, be made to raise oxygen tension and decrease metabolite concentration. This can best be accomplished by improving coronary blood flow, but also useful are restoration of the normal arterial oxygen content and correction and prevention of increased oxygen use and metabolite production. When forced to use an agent that directly stimulates myocardial strength, it is important to select one that does not further aggravate the disproportion between oxygen delivery and use. An increase in strength at the expense of a further reduction in myocardial oxygen tension and a further increase in the concentration of myocardial depressant metabolites can only lead to a decreased chance of survival.
Learn more about subscription options.
Register Now for a free account.
HADDY FJ. Pathophysiology and Therapy of the Shock of Myocardial Infarction. Ann Intern Med. 1970;73:809–827. doi: 10.7326/0003-4819-73-5-809
Download citation file:
Published: Ann Intern Med. 1970;73(5):809-827.
Acute Coronary Syndromes, Cardiology, Coronary Heart Disease, Emergency Medicine.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only