AcuteCVDays 2026 - Week 1 - Social Media

A 59-year-old woman presents with anterior STEMI and undergoes primary PCI to the LAD. Despite successful revascularisation, she remains hypotensive (BP 75/50 mmHg) with hypoperfusion (cool extremities, oliguria, lactate 6.2 mmol/L). She is treated with norepinephrine and dobutamine but deteriorates. Transthoracic echo shows severe LV systolic dysfunction without mechanical complications. A shock team is activated to consider mechanical circulatory support.

Which statement is NOT supported by current evidence and ESC guidelines?

VA-ECMO may be considered in selected patients with refractory cardiogenic shock despite optimal medical therapy

Routine early initiation of VA-ECMO in all STEMI-related cardiogenic shock improves survival and is recommended

LV unloading strategies may be considered in patients supported with VA-ECMO

Careful patient selection and early multidisciplinary shock team involvement is recommended

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