Cardiogenic Shock

What is cardiogenic shock?

Cardiogenic shock is a condition that arises from the inability of the heart to supply an adequate amount of blood to your body’s vital organs.

Because the heart has failed in its duty to pump enough nutrients around the body, blood pressure falls to very low levels, and organ failure sets in.

Cardiogenic shock is an uncommon occurrence, but it is usually an emergency if, and when it occurs.

Victims of cardiogenic shock in the past rarely survived the condition. But it is different today. Over half of cardiogenic shock patients survive with prompt treatment. This is attributed to advancements in medical science and technology, treatments, and early recognition of symptoms.

If you experience any cardiogenic shock symptoms, please do not hesitate to call your doctor or 911.

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Symptoms of shock

The symptoms may be acute. They include:

• Anxiety and confusion
• Rapid but very weak heartbeat
• The coldness of the extremities (fingers and toes), and sweating
• Fatigue
• Low urinary output or total absence of urine
• Fainting or dizziness
• Dyspnea (shortness of breath)
• Coma
• Chest pain if the shock is preceded by a heart attack

You must call 911 or visit an emergency room without delay if you have any of these symptoms. Early treatment results in a better outlook.

Causes of cardiogenic shock

Most cases of cardiogenic shock are attributed to a heart attack.

When you have a heart attack, blood flow through your arteries will be restricted or completely blocked. The restriction of blood flow can result in cardiogenic shock.

Other factors that may trigger a shock include:

• Blockage of a lung vessel (pulmonary embolism)
• A buildup of fluid around the heart, thus limiting its filling capacity (this condition is known as pericardial tamponade)
• Acute valvular regurgitation (the valves are suddenly damaged, and so allows the backflow of blood)
• Rupture of the heart wall due to high pressure
• The inability of the heart muscle to function at optimal capacity.
• Ventricular fibrillation (an arrhythmic condition in which your ventricles quiver)
• Ventricular tachycardia

Overdosing on certain drugs can affect the pumping ability of your heart leading to cardiogenic shock.

Risk factors

Factors that constitute a risk for cardiogenic shock include:

• A history of heart attack
• A buildup of plaque in the coronary arteries
• Chronic or prolong valvular disease (a disease that affects your heart’s valves).

For people who already have a weak heart, an infection can trigger a condition known as “mixed shock.” A mixed shock is a cardiogenic shock combined with a septic shock.

Diagnosis for cardiogenic shock

If you come in contact with a heart attack patient, or you think you may have one, get immediate medical help.

Seeking medical help without delay may prevent the occurrence of the shock and minimize damage to the heart. Cardiogenic shock becomes fatal if left untreated.

Your doctor will begin the diagnosis with a physical exam. The exam involves gauging of the blood pressure pulse.

You may be asked to do the following tests for confirmation of diagnosis:

Measurement of blood pressure

If there’s a cardiogenic shock, your blood pressure values will be on the low.

Blood tests

With a blood test, your doctor can tell whether your heart tissue is extensively damaged or not. He or she can also tell whether your oxygen values have decreased to low levels.

If the shock was due to a heart attack, there will be an increased concentration of enzymes associated with heart damage while blood oxygen levels will be lower than normal.

Electrocardiogram

An electrocardiogram is abbreviated as ECG. It is a medical procedure that shows the electrical activity that takes place in your heart. ECG for cardiogenic shock may show abnormal or irregular rates, like ventricular fibrillation or ventricular tachycardia. These arrhythmias may be responsible for the shock.

Echocardiography

Echocardiography shows an image of blood flow from your heart. It captures the structure of the heart and the activity that goes on in it.

Echocardiography may show a part of the heart devoid of motion, such as occurs in a heart attack, or it may also spot the weakness of your heart muscle or heart valve abnormality.

Swan-Ganz catheter

This catheter is inserted into the heart to evaluate the pressures reflecting its pumping action. A Swan-Ganz catheter should be inserted only by a cardiologist or a trained intensivist.

Treatment of cardiogenic shock

Treatment depends on the cause of the shock.

If your shock is caused by a heart attack, your doctor may place you on oxygen and thereafter insert a catheter into the arteries that supply the muscles of your heart.

If it is caused by an arrhythmia, your doctor may use electrical shock to correct the arrhythmia. The process of treating with an electric shock is known as cardioversion or defibrillation.

Your doctor may also place you on medications and remove fluid from your body to improve your blood pressure and help your heart to function better.

Complications of cardiogenic shock

If you leave your shock untreated, or if it is very severe, your organs will be starved of oxygen. This may result in temporary or permanent damage to your organ(s).

For instance, a cardiogenic shock patient is at risk of:

• Kidney or liver failure
• Brain damage
• Stroke
• Heart attack

Permanent damage may result in death.

Tips for prevention

The best way to prevent this condition is by preventing its primary cause. You can achieve this by preventing or treating:

• High blood pressure
• Obesity
• High blood cholesterol
• Smoking