Cardiogenic Shock

Any process that causes severe injury to the heart or interferes with its pumping action can cause shock. Any major organ will stop working if it loses its blood supply; thus, cardiogenic shock is a medical emergency and is usually fatal if not treated.quickly.

The signs and symptoms of cardiogenic shock are partly related to the organs that are failing and include:

• cold and clammy skin
• confusion
• decreased urination
• low blood pressure
• shortness of breath
• rapid breathing
• stroke, also called a brain attack, which is damage to the brain from not enough oxygen
• a weak pulse

Some symptoms and signs depend on the reason the heart is not pumping well. For example, the heart rate usually rises with the onset of cardiogenic shock, but could be low for other reasons.

Any disease that affects the ability of the heart to function can cause this condition. Some of the common causes of cardiogenic shock are as follows:

• a blood clot to the lungs, known as a pulmonary embolus
• a buildup of fluid around the heart, known as pericardial effusion
• certain irregular heart beats, called arrhythmias
• congestive heart failure
• a massive heart attack

A person with heart disease, should seek medical attention if his or her condition gets worse for any reason. Prompt medical attention may catch problems before shock occurs. Taking medicines as prescribed can also prevent shock.

Overall, the best way to prevent oneself from experiencing cardiogenic shock is to eliminate or control risk factors for coronary artery disease such as high blood pressure, diabetes, smoking, and high cholesterol.

Cardiogenic shock is usually easily apparent from one's medical history and physical examination. Figuring out the underlying cause is very important and requires further testing. For example, blood tests and a heart tracing, called an ECG, may be done if a heart attack is suspected. Plain or special X-ray tests are also frequently done.

If untreated, this condition usually causes death. The long-term effects depend on the cause and the speed of diagnosis and treatment. Permanent organ damage, especially to the kidney and brain, can occur.

There are no risks to others.

The goal of medical therapy is to improve your heart's ability to pump. The treatment depends on the underlying cause of the shock. Many different medicines and devices may be used to try to restore heart function and blood flow. Some of these include:

• adding or removing fluids, such as blood, water, or salt
• heart assist devices, such as a pacemaker
• heart medicines to help the heart pump more effectively, such as digitalis
• medicines to dissolve blood clots
• medicines to help open up, or dilate, certain blood vessels
• oxygen therapy
• surgery
• opening blocked vessels with a balloon (angioplasty)
• a ventilator, or artificial breathing machine

All medicines have possible side effects. Ventilators increase the risk of infection. Surgery can be complicated bybleeding, infection, or an allergic reaction to the anesthetic. In some cases, especially when heart surgery has to be performed as an emergency, the patient may not survive.

Survivors of cardiogenic shock need aggressive treatment and close monitoring of the underlying disease. For some people, the only option for survival beyond a few days to weeks is to undergo a heart transplant.

It is also important to evaluate and treat any damage to other organs which may have resulted from the episode of shock.

Results of blood tests and urine output are strictly monitored. Progress in the treatment of the underlying disease is also carefully monitored. X-rays and other tests may be required in some cases. Any new or worsening symptoms should be reported to the healthcare provider.