Mechanical Circulatory Support for the Failing Heart

Critical cardiogenic shock remains a problem with staggering mortality, with the best hope of survival depending on timely and aggressive intervention. This often requires the use of extracorporeal mechanical support in addition to vasoactive medications to manage patients through their initial insult. The decision to use such support must be made early in the clinical presentation, and is best done in a multidisciplinary fashion. In this article, we review the literature and provide an algorithm for the treatment of cardiogenic shock.