The ACC has announced a new Cardiogenic Shock Designation to improve outcomes for one of the most life-threatening complications of myocardial infarction. The new designation builds on the success of the ACC Chest Pain Center Accreditation, which has helped hospitals standardize and improve care for patients presenting with acute coronary syndrome, but has not previously addressed cardiogenic shock.

"The Cardiogenic Shock Designation is not just another layer of accreditation – it is a structured approach to improving survival in one of the highest-mortality conditions in cardiovascular medicine," says Michael C. Kontos, MD, FACC, chair-elect of ACC's Accreditation Oversight Committee. "The program clarifies roles, reduces variation, and strengthens coordination across the emergency department, Cath Lab, cardiac intensive care unit, and advanced heart failure teams."

Affecting nearly one in 10 patients suffering from STEMI, cardiogenic shock contributes to roughly 27,000 deaths each year in the U.S., and mortality remains disproportionately high in part due to lack of standardized protocols, performance measures and regional coordination.

The new designation has been developed in alignment with ACC's 2025 Concise Clinical Guidance (CCG) report on the evaluation and management of cardiogenic shock, and includes essential components, performance measures and system-of-care expectations that reinforce evidence-based practice. Access the CCG published in JACC.

Currently, care for patients with cardiogenic shock varies widely across hospitals as many lack clear pathways to recognize the condition early, escalate care quickly or obtain access to advanced therapies like temporary mechanical circulatory support. These gaps can lead to delays in treatment or failure to urgently transfer patients to other facilities, significantly worsening outcomes.

To address these disparities, particularly in underserved areas, the ACC is partnering with Johnson & Johnson's Abiomed on a grant program to support rural hospitals implementing the new ACC Chest Pain Center Accreditation with Shock Designation.

The program will fund 10 rural hospitals for one year, covering accreditation fees and participation in the NCDR Chest Pain – MI Registry, which supports ongoing data measurement and quality improvement. The initiative aims to extend lifesaving cardiogenic shock care to communities with limited access to advanced cardiac resources.

"ACC Chest Pain Center Accreditation has helped hospitals deliver faster, more consistent, evidence-based care for heart attack patients, but cardiogenic shock remains an unacceptably deadly gap in our systems of care," says ACC CEO Cathleen C. Gates. "By introducing a dedicated Cardiogenic Shock Designation and supporting rural hospitals, we are creating a framework that brings structure, accountability, and data-driven improvement to some of the highest risk patients in cardiovascular care, no matter where they live, with the goal of saving lives and improving long-term outcomes."

New Registry Enhancements Coming This Summer

The NCDR Chest Pain – MI Registry offers hospitals and care teams a comprehensive view of how patients with chest pain or acute coronary syndrome symptoms are managed across the entire care continuum.

Through a series of dashboards – including facility-level, professional-level, population analytics and intersystem care delivery – the registry provides participating organizations with the data-driven insights, analysis and research needed to inform clinical and operational decisions.

This summer, the registry is introducing new enhancements to streamline workflows, add targeted new features, strengthen coordination with emergency medical services and ensure full alignment with current national guidelines. The changes will also include updated shock-related data elements to be used for the new Cardiogenic Shock Designation.

"The updated Chest Pain – MI Registry includes new data points for cardiogenic shock patients that track shock identification, hemodynamic profiling and early escalation metrics," notes Kontos. "These additions create a shared data backbone for both the registry and the Cardiogenic Shock Designation, allowing teams to track performance, benchmark outcomes and close treatment gaps."

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Cardiology Magazine, ACC Publications, CM-Jul-Aug-2026, Shock, Cardiogenic, Chest Pain, Quality Improvement, Myocardial Infarction