Staging and Phenotyping of Cardiogenic Shock

The presentation, clinical trajectory and hemodynamic manifestation of cardiogenic shock is highly heterogenous. The diagnosis of cardiogenic shock should be followed by staging and phenotyping to guide appropriate management. A standardized staging schema allows communication of severity and acuity among clinicians and facilitates timely intervention. The SCAI staging schema is now well accepted and widely utilized. However, the agreement of clinician assessment (inter-observer agreement) based on the SCAI staging schema needs further study. Phenotyping of cardiogenic shock should characterize the respiratory, left and right heart systems. The phenotype-guided approach tailors therapeutic interventions, especialy mechanical circulatory support to the patient with cardiogenic shock. A schema for this combined staging and phenotyping of cardiogenic shock is presented in this chapter.