Benefits of Endovascular Hypothermia on Myocardial Preservation in the Setting of Cardiogenic Shock

Case Report. A 76-year-old female with carotid disease and a previous CVA presented in cardiogenic shock due to an inferior myocardial infarction (MI). Endovascular hypothermia was administered in the emergency room, reducing her body temperature from 98.6 ºF to 91.4 ºF. Attempted percutaneous revasculaization failed secondary to inability to pass a guidewire due to vessel tortuosity. Hypothermic conditions were maintained for three hours following transfer to the ICU. Following extubation on day three she had no residual neurologic deficits, despite protracted hypotension necessitating balloon pump and pressor support. The top panel demonstrates ST-segment resolution following endovascular hypothermia alone. Thirty-day SPECT imaging is also shown below. We postulate that endovascular hypothermia may be a beneficial means of myocardial and CNS preservation in the setting of cardiogenic shock.

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