Cardiogenic Shock Without Hypotension

Classic cardiogenic shock after acute MI is characterized by systemic hypotension (systolic blood pressure of less than 90 mm Hg) and evidence of peripheral hypoperfusion (oliguria and cold extremities). From a registry of 1068 patients enrolled in a cardiogenic shock trial, investigators compared 49 (5 percent) who exhibited peripheral hypoperfusion and systolic BPs of greater than 90 mm Hg (i.e., no hypotension) with 943 (88 percent) who met the criteria for classic cardiogenic shock; another 76 (7 percent) exhibited hypotension without evidence of hypoperfusion.

Compared with the classic-shock patients, the 49 patients with only hypoperfusion were more likely to have suffered anterior infarcts (71 percent vs. 53 percent, *P*=0.03). Howeve…