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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the national consensus document for the diagnosis&#44; risk stratification and treatment of patients with pulmonary thromboembolism &#40;PTE&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The prognostic stratification of PTE patients is based on their hemodynamic status&#44; and patients with hypotension &#40;sustained systolic blood pressure less than 90<span class="elsevierStyleHsp" style=""></span>mmHg&#41; or cardiogenic shock are considered high risk&#46; The recommended treatment for cardiogenic shock is the administration of fibrinolytics&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The term &#8220;shock&#8221; describes a clinical situation with circulatory failure causing hypoperfusion and hypoxia&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> We are indebted to Dr Max Harry Weil<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> for his major contribution to the understanding of the physiopathology of shock and his proposed classification of stages of shock&#44; published in the early 1970s&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> There are 4 potential&#44; non-exclusive&#44; forms of shock&#58; hypovolemic&#44; cardiogenic&#44; obstructive and distributive &#40;mainly associated with sepsis and anaphylaxis&#41;&#46; Cardiogenic shock occurs as a consequence of heart failure associated with diminished cardiac output&#46; It can be caused by acute myocardial infarction&#44; end-stage myocardial or valve disease&#44; myocarditis or arrhythmias&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Obstructive shock is less common and comprises different entities&#58; pulmonary embolism&#44; cardiac tamponade&#44; aortic dissection and tension pneumothorax&#46; The basic mechanism is increased afterload&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Our understanding is that the correct denomination would be obstructive shock&#44; or simply shock&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Nevertheless&#44; the clinical presentation of pulmonary embolism can be similar to that of cardiogenic shock&#44; and some authors consider the first as a form of the second&#46; Indeed&#44; there is no agreement on the denomination in the 2 referenced guidelines on the treatment of thromboembolic disease<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> from the American College of Chest Physicians and the National Institute for Health and Clinical Excellence&#46; The former only refers to the term &#8220;shock&#8221;&#44; while the latter calls it cardiogenic shock&#46; Irrespective of how this entity is called&#44; there is no doubt that the new consensus document is of invaluable help in patient management&#46;</p></span>"
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Letter to the Editor
Cardiogenic Shock and Pulmonary Embolism
Shock cardiogénico y embolia de pulmón
Carlos Romero Gómez
Corresponding author
carlosrg1968@gmail.com

Corresponding author.
, Josefa Andrea Aguilar García, María Dolores Martín Escalante
Servicio de Medicina Interna, Agencia Pública Hospital Costa del Sol, Marbella, Málaga, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the national consensus document for the diagnosis&#44; risk stratification and treatment of patients with pulmonary thromboembolism &#40;PTE&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The prognostic stratification of PTE patients is based on their hemodynamic status&#44; and patients with hypotension &#40;sustained systolic blood pressure less than 90<span class="elsevierStyleHsp" style=""></span>mmHg&#41; or cardiogenic shock are considered high risk&#46; The recommended treatment for cardiogenic shock is the administration of fibrinolytics&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The term &#8220;shock&#8221; describes a clinical situation with circulatory failure causing hypoperfusion and hypoxia&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> We are indebted to Dr Max Harry Weil<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> for his major contribution to the understanding of the physiopathology of shock and his proposed classification of stages of shock&#44; published in the early 1970s&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> There are 4 potential&#44; non-exclusive&#44; forms of shock&#58; hypovolemic&#44; cardiogenic&#44; obstructive and distributive &#40;mainly associated with sepsis and anaphylaxis&#41;&#46; Cardiogenic shock occurs as a consequence of heart failure associated with diminished cardiac output&#46; It can be caused by acute myocardial infarction&#44; end-stage myocardial or valve disease&#44; myocarditis or arrhythmias&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Obstructive shock is less common and comprises different entities&#58; pulmonary embolism&#44; cardiac tamponade&#44; aortic dissection and tension pneumothorax&#46; The basic mechanism is increased afterload&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Our understanding is that the correct denomination would be obstructive shock&#44; or simply shock&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Nevertheless&#44; the clinical presentation of pulmonary embolism can be similar to that of cardiogenic shock&#44; and some authors consider the first as a form of the second&#46; Indeed&#44; there is no agreement on the denomination in the 2 referenced guidelines on the treatment of thromboembolic disease<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> from the American College of Chest Physicians and the National Institute for Health and Clinical Excellence&#46; The former only refers to the term &#8220;shock&#8221;&#44; while the latter calls it cardiogenic shock&#46; Irrespective of how this entity is called&#44; there is no doubt that the new consensus document is of invaluable help in patient management&#46;</p></span>"
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Article information
ISSN: 15792129
Original language: English
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