Acute MI and Cardiogenic Shock with Dr. John Jarcho


Every medical resident will need to manage acute myocardial infarction at some stage. But what makes a patient with acute MI and cardiogenic shock more of a challenge to manage? NEJM Deputy Editor and Cardiologist Dr John Jarcho discusses the details around the pathophysiology and management in these patients and the recent paper, “One-Year Outcomes after PCI Strategies in Cardiogenic Shock.”


Introduction: 0:00
Risk Factors & Pathophysiology: 2:04
Clinical Scenario: 4:15
PCI, AMI & Cardiogenic Shock – SHOCK trial: 5:10
Areas of Controversy: 9:27
PCI, AMI & the Stable Patient – Compare-Acute trial: 12:07
PCI, AMI & Cardiogenic Shock – CULPRIT-SHOCK 30-day trial: 13:49
PCI, AMI & Cardiogenic Shock – CULPRIT-SHOCK follow-up: 18:40
Future Directions: 22:30
Take-aways: 24:56

This podcast is part of the series, Curbside Consults, which complements the foundational information in Rotation Prep by taking a deep dive into key topics with expert clinicians and educators. As we explore the details of pathophysiology and critique the evidence behind clinical practice, these conversations are intended to give you better understanding of the topic and greater confidence when treating your patients. 

John Jarcho, MD, is a cardiovascular medicine specialist at Brigham and Women's Hospital (BWH) in Boston, where he also completed his residency and fellowship training. He is an assistant professor of medicine at Harvard Medical School, and a Deputy Editor at the New England Journal of Medicine.

 Angela is a 2018-2019 NEJM editorial fellow. She is an endocrine fellow who trained at Flinders Medical Centre and the Royal Adelaide Hospital. Angela recieved her medical degree from the University of Adelaide, and masters of public health from the University of Sydney. Her clinical and research interests are in the areas of glucocorticoid and cardiovascular endocrinology and diabetes medicine.