An unusual cause of cardiogenic shock

Abstract

CASE PRESENTATION The incidence of ST-segment elevation acute myocardial infarction (STEMI) complicated with cardiogenic shock is between 5% and 8% and hospital and long-term mortality is up to three times higher compared to uncomplicated STEMI. The leading cause of STEMI is the sudden rupture of an atherosclerotic plaque, but there are other less common causes such as cardiac myxoma-induced embolization which, same as it happens with atherosclerotic events, can lead to hemodynamic instability and cardiogenic shock. We hereby present the case of a 61-year-old male with a past medical history of arterial hypertension and diabetes mellitus type 2 who experienced sudden loss of consciousness in his house; after remaining in this state for 10 minutes, the emergency medical team examined the patient and confirmed that the patient was experiencing confusional state and was hemodynamically unstable (arterial blood pressure, 60/40 mmHg). It was decided to proceed with orotracheal intubation and initiate the infusion of norepinephrine. The electrocardiogram performed confirmed the depression of the ST-segment of up to 5 mm at the inferior-lateral side, which is why the infarction code was activated and the patient was transferred to our center to perform a primary angioplasty procedure.