A condition known as cardiogenic shock occurs when the heart cannot pump enough blood to support the body's needs. If not treated promptly, cardiogenic shock can lead to organ failure and death. It can result from a severe heart attack, but it can also result from other heart problems or injuries.
Cardiogenic shock is caused by damage to the heart muscle, which occurs most often as a result of a heart attack. A heart attack occurs when a blood clot blocks the flow of blood to a part of the heart, depriving it of oxygen and nutrients. This weakens or kills the heart cells, affecting its ability to pump blood.
Other possible causes of cardiogenic shock include:
Inflammation of the heart muscle (myocarditis)
Infection of the heart valves (endocarditis)
Weakened heart from any cause (cardiomyopathy)
Drug overdose or poisoning
Abnormal heart rhythms (arrhythmias)
Rupture of the heart wall or valve
Blood clot in the lungs (pulmonary embolism)
The symptoms of cardiogenic shock are similar to those of a heart attack, but more severe. They include:
Chest pain or pressure
Pain or discomfort in the arms, back, neck, jaw, or stomach
Shortness of breath
Sweating
Nausea or vomiting
Lightheadedness or fainting
Rapid or irregular heartbeat
Low blood pressure
Weak pulse
Pale or cold skin
Reduced urine output
Confusion or restlessness
Cardiogenic shock is diagnosed based on the signs and symptoms, medical history, physical examination, and various tests. The tests may include:
Electrocardiogram (ECG): to measure the electrical activity of the heart and detect any abnormalities
Blood tests: to check the levels of oxygen, carbon dioxide, electrolytes, blood cells, and enzymes in the blood
Chest X-ray: to visualize the size and shape of the heart and lungs and look for any fluid buildup
Echocardiogram: to use sound waves to create images of the heart and assess its function and structure
Cardiac catheterization: to insert a thin tube into a blood vessel and guide it to the heart, where it can measure the pressure and blood flow in the heart chambers and arteries, and inject a dye to see any blockages
Coronary angiogram: to use X-rays and a dye to see the blood flow in the coronary arteries and locate any blockages
The treatment of cardiogenic shock aims to restore the blood flow to the heart and the rest of the body, and to repair the damage to the heart. The treatment may include:
Medications: to improve the heart function, reduce the workload of the heart, prevent blood clots, and treat the underlying cause of the shock
Oxygen therapy: to provide extra oxygen to the body through a mask or a tube in the nose
Fluids and blood transfusions: to increase the blood volume and pressure
Mechanical devices: to assist the heart in pumping blood, such as an intra-aortic balloon pump (IABP) or a ventricular assist device (VAD)
Surgery: to open up the blocked arteries, repair the heart valves or walls, or replace the heart with a donor organ (heart transplant)
The best way to prevent cardiogenic shock is to prevent or treat the conditions that can cause it, such as heart attack, heart disease, or high blood pressure. Some of the preventive measures include:
Quitting smoking
Eating a healthy diet low in saturated fat, salt, and sugar
Exercising regularly
Maintaining a healthy weight
Managing stress
Limiting alcohol intake
Taking medications as prescribed
Seeking medical attention promptly if experiencing any symptoms of a heart attack or cardiogenic shock
The causes, symptoms, diagnosis, treatment, and prevention of cardiogenic shock can help you or someone else survive this emergency.
