Penatalaksanaan Syok Kardiogenik

Oleh :

dr. Mia Amelia Mutiara Salikim

Penatalaksanaan awal syok kardiogenik adalah stabilisasi hemodinamik karena penyakit ini merupakan kondisi yang mengancam nyawa. Penanganan juga perlu mencakup tata laksana dari penyakit yang mendasari, seperti sindrom koroner akut (SKA). Pasien sebaiknya dirujuk ke Rumah Sakit tersier untuk tindakan spesialistik, seperti kateterisasi untuk reperfusi, perawatan intensif, dan bantuan sirkulasi mekanik.[1-4,7,21]

Persiapan Rujukan

Persiapan rujukan dari fasilitas kesehatan primer untuk syok kardiogenik dilakukan dengan pertama-tama melakukan stabilisasi hemodinamik agar pasien transportable. Bila tidak transportable maka tidak disarankan untuk dilakukan rujuk, terutama apabila perjalanan ke fasilitas kesehatan tersier sangat jauh dan lama.

Referensi

1. Tehrani BN, Truesdell AG, Psotka MA, Rosner C, Singh R, Sinha SS, et al. A Standardized and Comprehensive Approach to the Management of Cardiogenic Shock. JACC Heart Fail. 2020;8:879–91.
2. Vahdatpour C, Collins D, Goldberg S. Cardiogenic Shock. J. Am. Heart Assoc. 2019;8:e011991.
3. Sinha, S, Morrow, D, Kapur, N. et al. 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on the Evaluation and Management of Cardiogenic Shock: A Report of the American College of Cardiology Solution Set Oversight Committee. JACC. 2025 Apr, 85 (16) 1618–1641. https://doi.org/10.1016/j.jacc.2025.02.018
4. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur. Heart J. 2021;42:3599–726
5. Rodriguez MML, Guerrero CJV, Garzon JCA, Marin DFHPAO, Avila AFS, Padilla JDV. Cardiogenic shock. Interv. Cardiol. 2019;11:123
7. Ostadal P, Belohlavek J. What is cardiogenic shock? New clinical criteria urgently needed. Curr Opin Crit Care. 2024 Aug 1;30(4):319-323. doi: 10.1097/MCC.0000000000001172.
10. Soares ROS, Losada DM, Jordani MC, Évora P, Castro-E-Silva O. Ischemia/Reperfusion Injury Revisited: An Overview of the Latest Pharmacological Strategies. Int J Mol Sci. 2019;20(20):5034.
15. Lang CN, Kaier K, Zotzmann V, Stachon P, Pottgiesser T, von zur Muehlen C, et al. Cardiogenic shock: incidence, survival and mechanical circulatory support usage 2007–2017-insights from a national registry. Clin. Res. Cardiol. 2021;110:1421–30
21. Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI). Pedoman Tata laksana Sindrom Koroner Akut. Edisi ketiga, tahun 2020
22. van Diepen S, Katz JN, Albert NM, Henry TD, Jacobs AK, et al. Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association. Circulation. 2017;136:e232–e268. DOI: 10.1161/CIR.0000000000000525
37. Okutucu S, Fatihoglu SG, Lacoste MO, Oto A. Echocardiographic assessment in cardiogenic shock. Herz 2021;46:467–75
38. Reyentovich A, Thiele H. Treatment and prognosis of cardiogenic shock complicating acute myocardial infarction. Wolters Kluwer, Uptodate. 2026. https://www.uptodate.com/contents/treatment-and-prognosis-of-cardiogenic-shock-complicating-acute-myocardial-infarction
39. Schumann J, Henrich EC, Strobl H, et al. Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome. Cochrane Database Syst Rev. 2018;1(1):CD009669.
40. Avva U, Lata JM, Kiel J. Airway Management. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2026. https://www.ncbi.nlm.nih.gov/books/NBK470403/
41. Farmakis D, Agostoni P, Baholli L, Bautin A, Comin-Colet J, et al. A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus. International Journal of Cardiology 297 (2019) 83–90.
42. Shankar A, Gurumurthy G, Sridharan L, et al. A Clinical Update on Vasoactive Medication in the Management of Cardiogenic Shock. Clin Med Insights Cardiol. 2022;16:11795468221075064.
43. Naito H, Nojima T, Fujisaki N, et al. Therapeutic strategies for ischemia reperfusion injury in emergency medicine. Acute Med Surg. 2020;7(1):e501. Published 2020 Apr 13. doi:10.1002/ams2.501
44. Jordan M, Caesar J. Improving door-to-needle times for patients presenting with ST-elevation myocardial infarction at a rural district general hospital. BMJ Qual Improv Rep. 2016;5(1):u209049.w6736. Published 2016 Dec 19. doi:10.1136/bmjquality.u209049.w6736
45. Khan TM, Siddiqui AH. Intra-Aortic Balloon Pump. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2026. https://www.ncbi.nlm.nih.gov/books/NBK542233/
46. Tandukar S, Palevsky PM. Continuous Renal Replacement Therapy: Who, When, Why, and How. Chest. 2019;155(3):626-638. doi:10.1016/j.chest.2018.09.004

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Masuk atau Daftar

Nomor Ponsel Sudah Terdaftar

Masuk dengan Email

Masuk dengan Email

Masuk dengan Facebook

Penatalaksanaan Syok Kardiogenik

Referensi

Masuk atau Daftar

Artikel Terkait