What Is Cardiogenic Shock?
Cardiogenic shock occurs
when the heart has been damaged so much that it is unable to supply enough
blood to the vital organs of the body. As a result of the failure of the heart
to pump enough nutrients to the body, blood pressure falls and organs may begin
Cardiogenic shock is uncommon,
but when it does occur, it’s a serious medical emergency. According to the National
Institutes of Health,
almost no one survived cardiogenic shock in the past. Today, more than 50
percent of people who experience cardiogenic shock survive. This is due to
improved treatments and quicker recognition of symptoms.
However, the outlook is
still very poor if cardiogenic shock is ignored and untreated. You should contact
your doctor or call 911 immediately if you are experiencing any of the symptoms
of this condition.
Signs and Symptoms of Shock
Symptoms of cardiogenic
shock can appear very quickly. Symptoms may include the following:
and cold extremities (fingers and toes)
but weak heart beat (tachycardia)
- low or
absent urinary output (oliguria)
due to hyperventilation
shortness of breath
- coma, if
measures are not taken in time to stop the shock
It is vital to call 911
or visit an emergency room immediately if you are experiencing any of these
symptoms. The sooner the condition is treated, the better the outlook.
What Are the Causes of Cardiogenic Shock?
Cardiogenic shock is most
commonly the result of a heart attack. During a heart attack, the flow of blood
through the arteries is restricted or blocked completely. This restriction can
lead to cardiogenic shock.
Other conditions that
may cause cardiogenic shock include:
embolism (sudden blockage of an artery in the lung)
tamponade (fluid buildup around the heart reducing its filling capacity)
valvular regurgitation (damage to the valves allowing the backflow of blood)
of the wall of the heart (due to increased pressure)
of heart muscle to work properly (or at all in some cases)
fibrillation (an arrhythmia in which the lower chambers fibrillate or quiver)
tachycardia (an arrhythmia where the ventricles beat too fast)
Drug overdoses can also
affect your heart’s ability to pump blood and may lead to a cardiogenic shock.
What Are the Risk Factors?
Risk factors for
cardiogenic shock include:
history of myocardial infarction (heart attack)
buildup in the coronary arteries (arteries supplying blood to the heart)
valvular disease (disease affecting the valves of the heart)
How Is Cardiogenic Shock Diagnosed?
If you see someone
suffering from a heart attack or believe you may be suffering a heart attack,
get medical help immediately. Early medical attention may be able to prevent
cardiogenic shock and decrease damage to the heart. The condition can be fatal
if it’s left untreated.
To diagnose cardiogenic
shock, your doctor will complete a physical exam. The exam will gauge pulse and
blood pressure. Your doctor may request the following tests to confirm
Blood Pressure Measurement
This will show low values
in the presence of cardiogenic shock.
Blood tests can tell if
there has been serious damage to heart tissue. They can also tell if there has
been a decrease in oxygen values. If the cardiogenic shock was because of a
heart attack, there will be more enzymes linked to heart damage and less oxygen
than normal in your blood.
This procedure shows the
electrical activity of the heart. The test may show arrhythmias (irregular
heart rates) such as ventricular tachycardia or ventricular fibrillation. These
may be cause of the cardiogenic shock. An ECG may also show a quickened pulse.
This ultrasound imaging
of the structure and activity of the heart provides an image showing the flow
of blood. It may show a motionless part of the heart (such as in a heart attack)
or it may point to an abnormality with one of your heart’s valves.
This is a specialized pulmonary
catheter that is inserted into the heart to show its pumping activity. This
should only be placed by a trained Intensivist or Cardiologist.
To treat cardiogenic
shock, your doctor must find and treat the cause of the shock. If heart attack
is the cause, your doctor may give you oxygen and then insert a catheter into
the arteries supplying the heart muscle to remove the blockage.
If an arrhythmia is the
underlying cause, your doctor may try to correct the arrhythmia with electrical
shock. Electrical shock is also known as defibrillation or cardioversion. The
doctor may also give medications and fluid to improve blood pressure and increase
the amount of blood your heart pumps.
Tips to Prevent Cardiogenic Shock
occurrence of its root causes is the key to preventing cardiogenic shock. This
includes hypertension, smoking, obesity, and high levels of cholesterol. If you
have a previous history of heart attack, your doctor may prescribe medications
that can help prevent cardiogenic shock.
People with hypertension
or previous history of heart attack should keep their blood pressure under
control and use medications as directed by their doctors. Obese people should
exercise regularly and try to lose weight. People with high cholesterol should
lower their intake of fat in their diet. Smokers should try to quit smoking.
Most importantly, call 911 or visit an emergency room immediately if you
experience a heart attack or any of the symptoms associated with cardiogenic
shock. Your doctors can help prevent cardiogenic shock, but only if you get the
medical attention you need.