Surviving Cardiogenic Shock: Survival Rates Soar at Inova

Behnam N. Tehrani, MD, is a board-certified interventional cardiologist. He is medical director of the Inova Heart and Vascular Institute cardiac catheterization laboratories, and co-director of the Cardiogenic Shock Program. 

An innovative team-based approach to treating cardiogenic shock at Inova is helping more patients survive this dangerous condition — and we have the numbers to prove it.

Cardiogenic shock occurs when the heart is unable to pump enough blood throughout the body. About 1 in 10 people who experience a heart attack develop this life-threatening condition. In addition, up to 30 percent of patients with long-standing congestive heart failure can also develop cardiogenic shock. Untreated, cardiogenic shock can quickly progress to multi-organ failure.

Although new drugs and medical devices have been developed to treat cardiogenic shock, survival rates for patients with the condition have been uniformly poor for nearly two decades, stagnating at about 50 percent. In the last 2 years, physicians at the Inova Heart and Vascular Institute (IHVI) launched a team-based approach to managing this condition. As a result, we have seen significant improvements in patient outcomes, with survival rates currently at 74 percent.

We recently published our outcomes in the Journal of the American College of Cardiology.

Teaming up To Treat Heart Failure

In 2016, the Society for Cardiovascular Angiography and Interventions released a statement recommending a team-based approach to treating shock. Soon after, IHVI leaders developed a multidisciplinary Shock Team, made up of interventional cardiologists, cardiac surgeons, advanced heart failure specialists and intensivists.

The Shock Team is on call 24 hours a day, 7 days a week. Doctors at any of our Inova and referring hospitals can activate the Shock Team with a single call. The team members work together to determine the best treatment for each patient. Our goal: To provide timely, goal-oriented care to short-circuit the rapid downward spiral associated with this syndrome.

Impella, ECMO & Expertise

Over the last few decades, new tools and technologies have changed the way we treat cardiogenic shock. We commonly use circulatory support devices such as:

• Impella®. The world’s smallest heart pump, Impella supplements the heart’s pumping function, allowing the muscle to rest and recover.
• ECMO. Short for extracorporeal membrane oxygenation, ECMO temporarily replaces the function of the heart and lungs. ECMO uses a device to pump blood into an artificial lung and back into the bloodstream.
• TandemHeart. The TandemHeart is a small pump that delivers blood to the organs while allowing the heart’s left ventricle to rest.

These devices allow us to support critically ill patients and allow time for their heart muscles to recover. Cardiogenic shock is a complex syndrome that requires timely diagnosis and careful decision-making. By bringing experts from different specialties together from the time of diagnosis, we can provide truly innovative and cutting-edge care.

The doctors, nurses and other specialists at the Inova Heart and Vascular Institute lead the country in excellent patient outcomes and innovative heart research. Call 1-855-MY-INOVA (1-855-694-6682) to find an Inova Heart & Vascular physician, or find a doctor online.