Fig. 1.

Solving the hemodynamic support equation in cardiogenic shock.73 Illustration of the three primary clinical objectives in the setting of acute myocardial infarction complicated by cardiogenic shock. Circulatory support is defined by an increase in mean arterial pressure. Ventricular support is defined by a reduction in left ventricular (LV) pressure and volume, thereby reducing myocardial wall stress and oxygen demand. Coronary perfusion is defined by an increase in the trans-myocardial gradient, which is determined by the difference between coronary arterial and LV end-diastolic pressure. The net effect of optimal hemodynamic support is increased urine output, reduced serum lactate, reduced pulmonary capillary wedge pressure, resolution of ischemic electrocardiographic changes, and reduced levels of myocardial injury biomarkers such as CK-MB.