Appropriateness of Fluid Therapy in Cardiogenic Shock Management: A Systematic Review of Current Evidence.

Fluid therapy plays a pivotal role in maintaining tissue perfusion during the management of cardiogenic shock. Nevertheless, its application in this context is contentious, necessitating a balance between achieving adequate volume and avoiding fluid overload. This systematic review aimed to assess the outcomes of fluid therapy in cardiogenic shock. This review encompasses 11 studies involving 406 participants. Although some studies reported hemodynamic improvements following fluid administration, others presented contrasting findings. Studies that did not highlight the benefits of fluid therapy typically involved patients with unique comorbidities requiring specific etiology-based medical treatments. The most prevalent cause of cardiogenic shock, acute coronary syndrome, exhibited varying responses to fluid therapy based on the infarct location. In conclusion, fluid therapy plays a crucial role in cardiogenic shock management but necessitates integration into an appropriate treatment strategy, accounting for individual circumstances, comorbidities, and etiology. Further research is imperative to amass additional evidence regarding this issue.

An unexpected overlap syndrome of mitral valve prolapse with COVID-19 related myocarditis: case report from two patients.

The authors reported two patients with a history of asymptomatic mild mitral valve prolapse, a male in his late 40s (Case 1, vaccinated) and a female in her late 20s (Case 2, unvaccinated), who developed worsening (severe) mitral prolapse and New York Heart Association symptoms class III-IV after exposure to coronavirus disease 2019 with evidence of myocarditis on MRI. Both patients received similar 6-month of heart failure therapy; however, the outcomes did not affect the severity of their symptoms or mitral regurgitation. Subsequently, both patients underwent mitral valve surgery.