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Cardiogenic shock

Contents of this page:

Alternative Names   

Shock - cardiogenic

Definition    Return to top

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.

Causes    Return to top

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:

Symptoms    Return to top

Exams and Tests    Return to top

An examination will reveal:

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:

Treatment    Return to top

Cardiogenic shock is a medical emergency. Treatment requires hospitalization. The goal of treatment is to save your life and treat the cause of shock.

Medications may be needed to increase blood pressure and heart function, including:

When an arrhythmia is serious, urgent treatment may be needed to restore a normal heart rhythm. This may include:

You may receive pain medicine if necessary. Bed rest is recommended to reduce demands on the heart.

Getting oxygen lowers the workload of the heart by reducing tissue demands for blood flow.

You may receive intravenous fluids, including blood and blood products, if needed.

Other treatments for shock may include:

Outlook (Prognosis)    Return to top

In the past, the death rate from cardiogenic shock ranged from 80% - 90%. In more recent studies, this rate has improved to between 50% - 75%.

When cardiogenic shock is not treated, the outlook is not good.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms. Cardiogenic shock is a medical emergency.

Prevention    Return to top

You may reduce the risk by quickly and aggressively treating any related disorders.

References    Return to top

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.

Update Date: 4/23/2009

Updated by: 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.

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