Cardiogenic shock (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Assosciate Editor(s)-In-Chief: Prashanth Saddala M.B.B.S

Cardiogenic shock

Overview

What are the symptoms?

What are the causes?

Diagnosis

When to seek urgent medical care?

Treatment options

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

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Overview

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.

What are the symptoms of Cardiogenic shock?

What causes Cardiogenic 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:

  • 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
  • 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)

Diagnosis

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 (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:

When to seek urgent medical care?

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.

Treatment options

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:

You may also receive:

  • Pain medicine
  • Oxygen
  • Fluids, blood, and blood products through a vein (IV)

Other treatments for shock may include:

Medications to avoid

Patients diagnosed with cardiogenic shock should avoid using the following medications:

  • Acebutolol
  • Timolol
  • Nebivolol
    If you have been diagnosed with cardiogenic shock, consult your physician before starting or stopping any of these medications.


Prevention of Cardiogenic shock

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

What to expect (Outlook/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.

Possible complications

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000185.htm


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