American College of Cardiology issues concise clinical guidance on evaluation and management of cardiogenic shock
The American College of Cardiology (ACC) has issued its first Concise Clinical Guidance (CCG) to create more streamlined and efficient processes to implement best practices in patient care. This CCG focuses on evaluating and managing cardiogenic shock (CS), addressing important questions around clinical decision-making and providing actionable guidance for health care providers.
“ACC has a long history of developing clinical policy to complement clinical practice guidelines and to inform clinicians about areas where evidence is new and evolving or where randomized data is more limited. Despite this, numerous gaps persist in the evaluation and management of CS,” said Shashank S. Sinha, MD, MSc, FACC, writing committee chair and advanced heart failure and transplant cardiologist at the Inova Fairfax Medical Campus. Dr Sinha serves as Director, Cardiogenic Shock Program, Inova Health System; Medical Director of the Cardiac Intensive Care Unit, Cardiology; and Director of the Cardiovascular Critical Care Research Program. “Concise Clinical Guidance represents a key component of solution sets. They are highly focused, limited in scope, and aim to illustrate clinical decision-making processes using figures, tables, and checklists. They address patient populations who share certain characteristics, such as critically ill conditions like CS.”
CS is a life-threatening condition that occurs when the heart is unable to pump enough oxygen-rich blood to the body’s organs, resulting in hypotension (low blood pressure) and multi-organ damage or failure. CS has a high in-hospital mortality rate, ranging from 30 to 50%, and is one of the most common causes of cardiac intensive care admission.
The CCG addresses the importance of early recognition of CS for improving patient outcomes, providing comprehensive recommendations for its initial assessment, introducing a new mnemonic, SUSPECT CS, which includes laboratory markers along with clinical assessment for congestion-such as pulmonary edema, jugular venous distension and peripheral edema-and hypoperfusion.
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