Which of the following are reperfusion strategies in cardiogenic shock?

• A. Antibiotics and steroids
• B. Hyperbaric oxygen only
• C. Observation
• D. Thrombolytics, revascularization, balloon counterpulsation

Answer: (D)

In cardiogenic shock from an acute coronary event, the goal is to restore blood flow to the ischemic heart muscle and support the failing ventricle. Reperfusion strategies are therapies that directly re-establish coronary perfusion or improve the heart’s pumping to maintain circulation. Thrombolytics dissolve the clot causing the coronary occlusion, potentially restoring flow when rapid PCI isn’t available. Revascularization, including percutaneous coronary intervention or bypass surgery, physically restores blood supply to the affected coronary territory. Balloon counterpulsation with an intra-aortic balloon pump improves myocardial oxygen delivery and reduces afterload, increasing coronary perfusion during diastole and helping the heart recover while definitive reperfusion is performed. The other options don’t restore coronary blood flow or provide the same targeted support for the failing heart in this context.