| Subject | Contents |
| Definition | Cardiogenic shock is a disease state where the heart is damaged enough that it is unable to supply sufficient blood to the body.
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| Alternative Names | Shock - cardiogenic |
| Causes, incidence, and risk factors | Shock occurs whenever the heart is unable to pump enough blood for the needs of the body. Cardiogenic shock can be caused by disorders of the heart muscle , the valves, or the heart's electrical conduction system. Some related disorders include heart attack, heart failure , cardiomyopathy , rupture of the heart, abnormal heart rhythms, and heart valve disorders (especially leaky valves). |
| Symptoms | rapid pulsepulse may be weak (thready) rapid breathinganxiety , nervousness skin may feel cool to touch weakness , lethargy , fatigue decreased mental status loss of alertness loss of ability to concentrate restlessness , agitation , confusioncomaskin color pale or mottled profuse sweating , moist skin decreased urine output (or none) poor capillary refill |
| Signs and tests | An examination will reveal blood pressure '>low blood pressure (less than 90 systolic), and the blood pressure may drop more than 10 points when the patient stands up after lying down (orthostatic hypotension ). The pulse may be weak or absent (see pulse, weak or absent ). Procedures to diagnose cardiogenic shock may include: electrocardiogram coronary angiographyechocardiogram nuclear scans Other tests may be recommended to determine the cause of the heart's failure to function properly. Laboratory tests include: CBC type and cross-match blood for possible transfusion arterial blood gasblood chemistry ( chem-7 , chem-20 , electrolytes , cardiac enzymes) |
| Treatment | Cardiogenic shock is a medical emergency! Treatment requires hospitalization. The goal of treatment is to save the patient's life and treat the underlying cause of shock . Dopamine, dobutamine, epinephrine, norepinephrine, amrinone, or other medications may be required to increase blood pressure and heart functioning. Pain medicine may be given if necessary. Bed rest is recommended to reduce demands on the heart. Oxygen reduces the workload of the heart by reducing tissue demands for blood flow. Intravenous fluids, including blood and blood products, may be given if indicated. Other treatments of shock may include: cardiac pacing (pacemaker) heart monitoring, including hemodynamic monitoring, to guide treatment intra-aortic balloon counterpulsation (IABP) to improve heart and blood vessel ( cardiovascular ) function Note: Surgical repair of the cause should be performed if it is feasible. Balloon angioplasty ( PTCA ) may be an alternative to surgery in some cases. |
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| Expectations (prognosis) | Approximately 80% of cases of cardiogenic shock are fatal, even with treatment. |
| Complications | kidney damage brain damage liver damage |
| Calling your health care provider | Go to the emergency room or call the local emergency number (such as 911) if symptoms are present. Cardiogenic shock is a medical emergency. |
| Prevention | The risk may be reduced by prompt, aggressive treatment of related disorders. |
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