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Cardiogenic shock - Symptom

Alternative Names

Shock - cardiogenic

Symptoms:

Anxiety, nervousness
Coma
Decreased mental status
- Loss of ability to concentrate
- Loss of alertness
Decreased urine output (or none)
Pale skin color or blotchy (mottled) skin
Profuse sweating, moist skin
Rapid breathing
Rapid pulse
Restlessness, agitation, confusion
Skin that feels cool to the touch
Weak (thready) pulse
Weakness, lethargy, fatigue

Signs and tests:

An examination will reveal low blood pressure (less than 90 systolic). The blood pressure may drop more than 10 points when you stand up after lying down (orthostatic hypotension). The pulse may be weak (thready).

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.

Tests include:

Other tests may be recommended to determine why the heart is not functioning properly.

Laboratory tests include:

Arterial blood gas
Blood chemistry (chem-7, chem-20, electrolytes, cardiac enzymes)
CBC

Reviewed last on: 5/15/2008
Alan Berger, MD, Assistant Professor, Divisions of Cardiology and Epidemiology, University of Minnesota, Minneapolis, MN. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

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-Eevation 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. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa:Saunders; 2007:chap 51.

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