Cardiogenic Shock

What is cardiogenic shock?

Shock is a condition in which the blood pressure is very low and the body doesn't get all the blood it needs. Shock can be caused by a rapid loss of a lot of blood, by allergic reactions, or because the heart is not pumping well. Lack of blood flow because the heart is not pumping well is called cardiogenic shock. Shock is an emergency and medical care is needed right away.

How does it occur?

The major cause of cardiogenic shock is a heart attack. A heart attack happens when the heart muscle doesn't get enough blood and oxygen. The lack of blood makes the heart muscle weak or sometimes kills part of the muscle. If the muscle is hurt, it means the heart cannot pump blood very well.

If only a small part of the heart muscle is hurt, the heart can continue pumping blood until the damage is healed. However, if 40% or more of the heart muscle does not get enough blood and is hurt, the heart cannot pump enough blood to the body, and cardiogenic shock occurs.

What are the symptoms?

The severe chest pain of a heart attack is what usually makes people go to the hospital or see a doctor. If the heart damage is very bad, the signs and symptoms of cardiogenic shock may show up right away. If the heart attack is less severe, shock may take several hours to show up. The major symptom of shock is low blood pressure. People with low blood pressure often have the following symptoms:

• extreme weakness
• sweating
• pale skin color
• cool hands and feet
• less urine output
• nausea
• fast, shallow breathing.

How is it treated?

People with cardiogenic shock need to be in a cardiac intensive care unit. If shock is caused by a heart attack, the first treatment is to try to restore blood flow to the damaged part of the heart muscle. It is also important to get the blood pressure up and improve blood flow to the tissues. There are medicines to help.

Medicine may not be enough to treat the shock. The heart muscle may need help pumping. Mechanical devices such as an intra-aortic balloon pump (IABP) may be used for a short time. It helps the heart work less hard and increases blood flow to the heart.

What are the results of treatment of cardiogenic shock?

Untreated shock usually causes death. Even with treatment, only some people with cardiogenic shock survive. Survival depends on the cause of the shock, whether the person has other diseases, and how long it takes to get treatment.