Transforming Outcomes - Multi-Disciplinary Approach for the Failing Heart
NUHCS held the first Cardiogenic Shock Masterclass
for medical professionals in the Asia-Pacific region
PULSE Issue 42 | February 2024
Rising in incidence in recent years,
Cardiogenic Shock (CS) – a devastating
condition where there is sudden
dysfunction of the heart leading
to low blood pressure and poor
organ perfusion – has seen patient
survival rates plateau at 40% to
50%. Meanwhile, the advent of
new treatment protocols and the
introduction of Mechanical Circulatory
Support (MCS) devices has resulted
in a paradigm shift in the care and
management of the cardiac condition.
Shining light into the serious medical
emergency, the National University
Heart Centre, Singapore (NUHCS),
organised its inaugural NUHCS
Cardiogenic Shock Masterclass on 13
May 2023 for medical professionals
to learn more about this increasingly
prevalent condition. Attended by more
than 260 participants from around the
region, the virtual webinar uncovered
emerging technical advances and new
directives in the evolving CS field.
Recognising the importance of early
detection and prompt intervention to
tackle this life-threatening condition
is crucial for effective patient
care. Studies have shown that the
inclusion of multidisciplinary insight,
complemented by increased awareness
and greater agility in haemodynamic-guided management through a
protocolised bundle-of-care approach,
is key to restoring vital life signs and
improving the outcomes of this group
of fragile cardiac patients.
Experts from the Department of
Cardiology, NUHCS, including Dr
Anand Ambhore, Clinical Director of
the Coronary Care Unit and Senior
Consultant, Asst Prof Lim Shir Lynn,
Director of Clinical Trial Unit and Senior
Consultant, Asst Prof Robin Cherian,
Consultant and Dr Shaun Chook,
Associate Consultant, Department of
Cardiology, NUHCS, spoke on the basics
of cardiogenic shock and the latest
therapeutics available. This includes
updates on the latest definitions
and classification systems in CS, the utilisation of invasive haemodynamics
in treatment, to MCS devices available
with echocardiography, an essential
tool for patients on MCS devices, and
the patient specifics to consider during
implementation.
Adj A/Prof Ramanathan Kollengode,
Senior Consultant, Division of
Cardiothoracic Intensive Care Unit
(CTICU), Department of Cardiac,
Thoracic and Vascular Surgery
(CTVS), NUHCS, then introduced the
role of Extracorporeal Membrane
Oxygenation (ECMO) in CS, while Asst
Prof Lin Weiqin, Clinical Director of
Heart Failure Programme and Senior
Consultant, Department of Cardiology,
NUHCS expounded on his expertise as
chief of the CS heart team, to highlight
on the management and approach to
forming a robust CS Team.
Synthetising the key learning pointers
during the masterclass, Asst Prof
Lin reiterated the components of
shock management including the
strengthening of protocol-based
workflows, early diagnosis and
initiation of CS therapies, and a multi-disciplinary, team-based care approach
geared towards improved patient
outcomes — guided by the principle
of "better", more comprehensive
management, rather than pursuing
“faster” as a central paradigm.
It is hoped that through the
masterclass, all attendees have
developed a deeper appreciation of the
nuances of CS management to help
make further inroads in enhancing
decision-making during the treatment
procedure, and gained valuable
insights on setting up a similar specialist
team in their hospital, to combat this
life-threatening condition.
