Mechanism of Cardiogenic Shock

• The mechanism of shock following acute myocardial infarction is still controversial. Xumerous investigators have applied techniques such as: (a) ligation of the different branches of the coronary arteries," (b) chemical or traumatic methods to produce myoeardial injury/" and (c) introduction of einbolizing particles into the coronary circulation." The results are conflicting, largely because the methods used to modify the coronary circulation necessitated either the direct approach of opening the chest for coronary ligation or einbolization, or the indirect approach of injecting einbolizing particles through an aortic catheter in the vicinity of the coronary ostia. Although the latter procedure may be performed in animals Avithout opening the thorax, it not only lacks selectivity of distribution of the einbolizing particles in the coronary vascular bed, but spills a considerable share of the emboli into the systemic, circulation.