65M post-anterior STEMI with primary PCI done. Now in ICU with BP 82/50, HR 118, lactate 4.5, cold extremities, urine output 10ml/hr. Echo shows EF 20%, no mechanical complication. On low-dose dopamine currently. Should we switch to norepinephrine? Add dobutamine? Or go straight to IABP or Impella? What does the CULPRIT-SHOCK trial teach us about culprit-only vs multivessel PCI in this scenario?
For peer discussion only — not a substitute for clinical judgment. Verify with authoritative sources.
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