Cardiogenic shock is when the heart has been damaged so much that it is unable to supply enough blood to the organs of the body.
Shock – cardiogenic
Causes, incidence, and risk factors
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
A large section of heart muscle that no longer moves well or does not move at all
Breaking open (rupture) of the heart
muscledue to damage from the heart attack
Dangerous heart rhythms, such as
ventricular tachycardia, ventricular fibrillation, or supraventricular tachycardia
Pressure on the heart due to a build up of fluid around it (pericardial tamponade)
Tear or rupture of the muscles or tendons that support the heart valves, especially the mitral valve
Tear or rupture of the wall (septum) between the left and right ventricles (lower heart chambers)
Very slow heart rhythm (bradycardia) or problem with the electrical system of the heart (heart block)
- Chest pain or pressure
- Decreased urination
Fast breathing Fast pulse Heavy sweating, moist skin
- Loss of alertness and ability to concentrate
Restlessness, agitation, confusion
- Shortness of breath
- Skin that feels cool to the touch
Pale skin coloror blotchy skin
- Weak (thready) pulse
Signs and tests
An examination will show:
Low blood pressure (usually less than 90 systolic)
Blood pressure drops more than 10 points when you stand up after lying down (orthostatic hypotension)
Weak (thready) pulse
To diagnose cardiogenic shock, a catheter (tube) may be placed in the lung artery (
Cardiac catheterization Chest x-ray
- Nuclear scan of the heart
Other studies may be done to find out why the heart is not working properly.
Lab tests include:
Arterial blood gas
Blood chemistry( chem-7, chem-20, electrolytes)
Cardiac enzymes (troponin, CKMB)
Complete blood count (
Thyroid stimulating hormone (TSH)
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. They are not usually used for a long time.
When a heart rhythm disturbance (dysrhythmia) is serious, urgent treatment may be needed to restore a normal heart rhythm. This may include:
Electrical “shock” therapy (defibrillation or cardioversion)
Implanting a temporary pacemaker
Medications given through a vein (intravenous)
You may also receive:
- Pain medicine
- Fluids, blood, and blood products through a vein (IV)
Other treatments for shock may include:
Cardiac catheterizationwith coronary angioplastyand stenting
- Heart monitoring to guide treatment
- Heart surgery (
coronary artery bypass surgery, heart valve replacement, left ventricular assist device)
- Intra-aortic balloon counterpulsation (IABP) to help the heart work better
- Ventricular assist device
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.
- Brain damage
- Liver damage
Calling your health care provider
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:
- Quickly treating its cause (such as heart attack or heart valve problem)
- Preventing and treating the risk factors for heart disease, such as diabetes, high blood pressure, high cholesterol and triglycerides, or tobacco use