Cardiogenic Shock
Definition
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.
Alternative Names
Shock - cardiogenic
Causes, incidence, and risk factors
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:
A large section of heart muscle that no longer moves well or does not move at all
Breaking open (rupture) of the heart
muscle due to damage from the heart attack
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)
References
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.
Review Date: 5/23/2011
Reviewed By: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Shock - cardiogenic
Symptoms
Signs and tests
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.
Tests include:
Other studies may be done to find out why the heart is not working properly.
Lab tests include:
References
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.
Review Date: 5/23/2011
Reviewed By: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Shock - cardiogenic
Treatment
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:
Dopamine
Epinephrine
Norepinephrine
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:
Electrical "shock" therapy (defibrillation or cardioversion)
Implanting a temporary pacemaker
Medications given through a vein (intravenous)
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:
Expectations (prognosis)
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.
Complications
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.
References
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.
Review Date: 5/23/2011
Reviewed By: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Shock - cardiogenic
Prevention
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
References
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.
Review Date: 5/23/2011
Reviewed By: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 5/23/2011
Reviewed By: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.