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Cardiogenic shock

Shock - cardiogenic

Cardiogenic shock takes place when the heart has been damaged so much that it is unable to supply enough blood to the organs of the body.

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Heart, section through the middle

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Causes

The most common causes are serious heart conditions. Many of these occur during or after a heart attack (myocardial infarction). These complications include:

Cardiogenic shock occurs when the heart is unable to pump as much blood as the body needs. It can happen even if there hasn't been a heart attack if 1 of these problems occurs and your heart function drops suddenly.

Symptoms

Symptoms include:

Exams and Tests

An exam will show:

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 well.

Tests include:

Other studies may be done to find out why the heart is not working properly.

Lab tests include:

Treatment

Cardiogenic shock is a medical emergency. You will need to stay in the hospital, most often in the Intensive Care Unit (ICU). 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 often 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:

Other treatments for shock may include:

Outlook (Prognosis)

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

When cardiogenic shock is not treated, the outlook is very poor.

Possible Complications

Complications may include:

When to Contact a Medical Professional

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.

Prevention

You may reduce the risk of developing cardiogenic shock by:

Related Information

Shock
Muscle cramps
Heart failure - overview
Cardiomyopathy
Injury - kidney and ureter

References

Felker GM, Teerlink JR. Diagnosis and management of acute heart failure. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier Saunders; 2018:chap 24.

Hollenberg SM. Cardiogenic shock. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 107.

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Review Date: 5/16/2018  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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