Cardiogenic shock is a state in which the heart has been damaged so much that it is unable to supply enough blood to the organs of the body.
Shock - cardiogenic
Shock occurs whenever the heart is unable to pump as much blood as the body needs.
The most common causes are serious heart complications. Many of these occur during or after a heart attack (myocardial infarction). These complications include:
An examination will reveal:
To diagnose cardiogenic shock, a catheter (tube) may be placed in the pulmonary artery (right heart catheterization). Measurements often indicate that blood is backing up into the lungs and the heart is not pumping properly.
Other studies may be recommended to determine why the heart is not functioning properly.
Laboratory tests include:
Cardiogenic shock is a medical emergency. Treatment requires hospitalization, usually in the Intensive Care Unit. The goal of treatment is to identify and treat the cause of shock in order to save your life.
Medications may be needed to increase blood pressure and improve heart function, including:
When a heart rhythm disturbance (dysrhythmia) is serious, urgent treatment may be needed to restore a normal heart rhythm. This may include:
You may receive pain medicine if necessary. Bed rest is recommended to reduce demands on the heart.
Receiving oxygen, either by a nasal tube or mask over the mouth, lowers the workload of the heart by reducing tissue demands for blood flow.
You may receive intravenous fluids, including blood and blood products, if needed.
Other treatments for shock may include:
In the past, the death rate from cardiogenic shock ranged 80 - 90%. In more recent studies, this rate has decreased to 50 - 75%.
When cardiogenic shock is not treated, the outlook is poor.
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of cardiogenic shock. Cardiogenic shock is a medical emergency.
You may reduce the risk of developing cardiogenic shock by:
Jones AE, Kline JA. Shock. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 4.
Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol. 2007;50:e1-e57.
Antman EM. ST-elevation myocardial infarction: management. In: Libby P, Bonow RO, Mann DL, Zipes DP. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders; 2007:chap 51.