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Shock - cardiogenic
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 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 show:
To diagnose cardiogenic shock, a catheter (tube) may be placed in the lung artery (right heart catheterization). Tests may show that blood is backing up into the lungs and the heart is not pumping properly.
Other studies may be done to find out why the heart is not working properly.
Lab tests include:
Cardiogenic shock is a medical emergency. You will need to stay in the hospital, usually in the Intensive Care Unit. The goal of treatment is to find and treat the cause of shock to save your life.
You may need medicines to increase blood pressure and improve heart function, including:
These medicines may help in the short-term, but they should not be used over the long-term.
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 needed. Bed rest is recommended to reduce demands on the heart.
Getting oxygen by a nasal tube or mask worn over the mouth lowers the workload of the heart helping the tissue of the body need less blood.
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 from 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:
Gheorghiade M, Filippatos GS, Felker GM. Diagnosis and management of acute failure syndromes. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders; 2011:chap 27.
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