{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T13:23:17Z","timestamp":1765459397562,"version":"3.46.0"},"reference-count":69,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Cardiogenic shock (CS) is a heterogeneous pathophysiological state with high mortality, despite the development of cardiac intensive care units (CICUs) and the advanced treatments applied. The cornerstones of therapy that have been proposed in many algorithms are intravenous (i.v.) pressors and devices for mechanical circulatory support (MCS), depending on the CS profile (left, right, or biventricular involvement), etiology (acute myocardial infarction, heart failure, or other) and SCAI stage (A to E, with MCS generally recommended for Stages C\u2013E). There are many gaps in the evidence regarding i.v. medications and devices, with the existing data being controversial. Moreover, there are differences in the devices\u2019 availability and, as a result, a lack of experience in many centers. In this review article, an algorithm for the management of CS is proposed, and the gaps in every step are presented. Early clinical suspicion that leads to prompt diagnosis, health system organization, large-scale trials, and the configuration of national or regional shock centers could bridge the current therapeutic gaps and balance disparities in the management of CS in order to improve outcomes.<\/jats:p>","DOI":"10.3390\/jcdd12120489","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T12:57:41Z","timestamp":1765457861000},"page":"489","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Proposed Algorithm for the Management of Patients with Cardiogenic Shock Based on Contemporary Knowledge and Gaps in Evidence"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3578-1009","authenticated-orcid":false,"given":"Aidonis","family":"Rammos","sequence":"first","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos D.","family":"Floros","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5089-2350","authenticated-orcid":false,"given":"Ioannis","family":"Tzourtzos","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilektra E.","family":"Stamou","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8778-2303","authenticated-orcid":false,"given":"Petros","family":"Kalogeras","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8840-4349","authenticated-orcid":false,"given":"Ioanna","family":"Samara","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, Hopitaux du Pays du Mont Blanc, 74700 Sallanches, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9120-0184","authenticated-orcid":false,"given":"Konstantinos C.","family":"Siaravas","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-5311","authenticated-orcid":false,"given":"Vasileios","family":"Bouratzis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1721-2539","authenticated-orcid":false,"given":"Aris","family":"Bechlioulis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1336-0211","authenticated-orcid":false,"given":"Xenofon M.","family":"Sakellariou","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9900-9659","authenticated-orcid":false,"given":"Katerina K.","family":"Naka","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8834-4462","authenticated-orcid":false,"given":"Lampros K.","family":"Michalis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina, 45500 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e021061","DOI":"10.1161\/JAHA.121.021061","article-title":"Fifteen-Year Trends in Incidence of Cardiogenic Shock Hospitalization and In-Hospital Mortality in the United States","volume":"10","author":"Osman","year":"2021","journal-title":"J. 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