Cardiogenic shock

Cardiogenic shock is a medical emergency causing low blood flow to the body's organs because the heart is not working properly. Signs of weak blood flow include

Cardiogenic shock
Cardiogenic shock
Ultrasound image after cardiogenic shock due to myocarditis[1]
Medical specialtyCardiology, emergency medicine
SymptomsFatigue, rapid heartbeat, shortness of breath, hypotension, sweating, chest pain, dizziness or lightheadedness, nausea, decreased level of consciousness[2]
ComplicationsWorsening of or causing heart failure and/or heart block, serious arrhythmias such as ventricular fibrillation, cor pulmonale, respiratory or kidney or liver dysfunction or failure, multiple organ dysfunction syndrome, cardiac arrest, death
CausesHeart attack, myocarditis, endocarditis, certain medications and substances,[2] blunt cardiac injury
Risk factorsHeart failure, old age, hypertension[2]
Prognosis60% mortality in cardiogenic shock not related to heart attack[3] 30-day mortality 40% for cardiogenic shock due to heart attack[4]

Cardiogenic shock is a medical emergency causing low blood flow to the body's organs because the heart is not working properly. Signs of weak blood flow include low urine production, cool arms and legs, and decreased level of consciousness. People may also have bad low blood pressure.

Causes of cardiogenic shock include cardiomyopathic, arrhythmic, and mechanical. Cardiogenic shock is most commonly caused by a heart attack. 5-10% of cardiogenic shocks are caused by heart attacks.[5]

Treatment of cardiogenic shock depends on the cause. If cardiogenic shock is caused because of a heart attack, attempts to open the heart's arteries could help.[4] Some medications, such as dobutamine and milrinone, help fix the heart's ability to contract and can also be used.[4] When these do not work, more advanced options such as mechanical support devices could help.[4]

Cardiogenic shock is a condition that is difficult to reverse fully. Mortality rates for cardiogenic shock are high but have been decreasing in the United States. Some studies have said that this is possibly related to new treatment advances. The 30-day mortality rate for cardiogenic shock after a heart attack is 40%, with a 1-year mortality rate of 50%.[4] However, the mortality rates remain high since multiple organ failure can be caused by cardiogenic shock.[6]

References

  1. ↑ "UOTW #7 – Ultrasound of the Week". Ultrasound of the Week. 30 June 2014. Retrieved 27 May 2017.
  2. ↑ 2.0 2.1 2.2 "Cardiogenic shock – Symptoms and causes". Mayo Clinic. Retrieved 22 May 2020.
  3. ↑ Schrage B, Becher PM, Goßling A, Savarese G, Dabboura S, Yan I, et al. (April 2021). "Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock". ESC Heart Failure. 8 (2): 1295–1303. doi:10.1002/ehf2.13202. PMC 8006704. PMID 33605565.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 Samsky, Marc D.; Morrow, David A.; Proudfoot, Alastair G.; Hochman, Judith S.; Thiele, Holger; Rao, Sunil V. (9 November 2021). "Cardiogenic Shock After Acute Myocardial Infarction: A Review". JAMA. 326 (18): 1840–1850. doi:10.1001/jama.2021.18323. PMC 9661446. PMID 34751704.
  5. ↑ Vahdatpour C, Collins D, Goldberg S (April 2019). "Cardiogenic Shock". Journal of the American Heart Association. 8 (8) e011991. doi:10.1161/JAHA.119.011991. PMC 6507212. PMID 30947630.
  6. ↑ Thiele H, de Waha-Thiele S, Freund A, Zeymer U, Desch S, Fitzgerald S (August 2021). "Management of cardiogenic shock". EuroIntervention. 17 (6): 451–465. doi:10.4244/EIJ-D-20-01296. PMC 9724885. PMID 34413010.

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