Physiological Concepts of Cardiogenic Shock Using Pressure-Volume Loop Simulations: A Case-Based Review.

Cardiogenic shock (CS) is a complex syndrome of end-organ hypoperfusion that requires timely and thorough decision making. While many pathophysiologic and technical principles have been delineated in this issue, the purpose of this case-based report is to reflect upon some of these principles in the context of real-life scenarios. Given the obvious lacuna of evidence-based recommendations in CS, the authors provide a rationale for their decision-making process. The first case is a young post-heart-transplant patient with graft failure who was in a state of biventricular failure and restrictive physiology and required acute mechanical circulatory support (MCS). The second case is a patient who suffered a mechanical complication after experiencing an acute myocardial infarction that required MCS.