Clinical Appraisal of Shock Following Acute Myocardial Infarction

Abstract

An attempt has been made to define clinically recognizable forms of cardiogenic shock. ‘Vasoreactive’ shock, characterized by a cold and sweaty skin, oliguria and moderate to gross mental dysfunction, was managed by reducing the vascular resistance with phenoxybenzamine. ‘Vasolytic’ shock, suggested by a grey or flushed facies, slightly reduced urinary output, and mild to moderate mental impairment, was treated with aramine. Patients with clinical features between these two extremes (‘intermediate’ group) were initially treated according to the most prominent clinical features. Further management was based on the assessment of easily measurable parameters such as central venous pressure, acid-base status, arterial pressure, temperature, etc. The mortality rate of the entire group of 31 patients was 42%.