Cardiogenic shock occurs when the heart is unable to supply enough blood to the vital organs of the body.
As a result of the failure of the heart to pump enough nutrients to the body, blood pressure falls and organs may begin to fail.
Cardiogenic shock is uncommon, but when it does occur, it’s a serious medical emergency.
Almost no one survived cardiogenic shock in the past. Today, half of the people who experience cardiogenic shock survive with prompt treatment. This is due to improved treatments and quicker recognition of symptoms.
Contact your doctor or call 911 immediately if you’re experiencing any of the symptoms of this condition.
Symptoms of cardiogenic shock can appear very quickly. Symptoms may include the following:
- confusion and anxiety
- sweating and cold extremities, like fingers and toes
- rapid but weak heartbeat
- low or absent urinary output
- sudden shortness of breath
- fainting or dizziness
- coma, if measures aren’t taken in time to stop the shock
- chest pain, if preceded by a heart attack
It’s vital to call 911 or immediately go to an emergency room if you’re experiencing any of these symptoms. The sooner the condition is treated, the better the outlook.
Cardiogenic shock is most commonly the result of a heart attack.
During a heart attack, the flow of blood through the arteries is restricted or blocked completely. This restriction can lead to cardiogenic shock.
Other conditions that may cause cardiogenic shock include:
- sudden blockage of a blood vessel in the lung (pulmonary embolism)
- fluid buildup around the heart, reducing its filling capacity (pericardial tamponade)
- damage to the valves, allowing the backflow of blood (sudden valvular regurgitation)
- rupture of the wall of the heart due to increased pressure
- inability of heart muscle to work properly, or at all in some cases
- an arrhythmia in which the lower chambers fibrillate or quiver (ventricular fibrillation)
- an arrhythmia where the ventricles beat too fast (ventricular tachycardia)
Drug overdoses can also affect the heart’s ability to pump blood and may lead to cardiogenic shock.
Risk factors for cardiogenic shock include:
- previous history of heart attack
- plaque buildup in the coronary arteries (arteries supplying blood to the heart)
- long-term valvular disease (disease affecting the valves of the heart)
In those with a preexisting weak heart, an infection can also trigger something called “mixed” shock. This is cardiogenic shock plus septic shock.
If you see someone having a heart attack or believe you may be having a heart attack, get medical help immediately.
Early medical attention may be able to prevent cardiogenic shock and decrease damage to the heart. The condition is fatal if it’s left untreated.
To diagnose cardiogenic shock, your doctor will complete a physical exam. The exam will gauge pulse and blood pressure.
Your doctor may request the following tests to confirm diagnosis:
Blood pressure measurement
This will show low values in the presence of cardiogenic shock.
Blood tests can tell whether there’s been serious damage to heart tissue. They can also tell whether there’s been a decrease in oxygen values.
If the cardiogenic shock was because of a heart attack, there will be more enzymes linked to heart damage and less oxygen than normal in your blood.
This procedure shows the electrical activity of the heart. The test may show irregular heart rates (arrhythmias), such as ventricular tachycardia or ventricular fibrillation. These arrhythmias may be the cause of the cardiogenic shock.
An ECG may also show a quickened pulse.
This test provides an image showing the heart’s blood flow by looking at the structure and activity of the heart.
It may show a motionless part of the heart, such as in a heart attack, or it may point to an abnormality with one of your heart’s valves or overall weakness of the heart muscle.
This is a specialized catheter that’s inserted into the heart to measure pressures that reflect its pumping function. This should only be placed by a trained intensivist or cardiologist.
To treat cardiogenic shock, your doctor must find and treat the cause of the shock.
If heart attack is the cause, your doctor may give you oxygen and then insert a catheter into the arteries supplying the heart muscle to remove the blockage.
If an arrhythmia is the underlying cause, your doctor may try to correct the arrhythmia with electrical shock. Electrical shock is also known as defibrillation or cardioversion.
Your doctor may also give medications and remove fluid to improve blood pressure and the function of your heart.
If cardiogenic shock is severe or left untreated for too long, your organs won’t receive an adequate oxygen supply through the blood. This can lead to temporary or permanent organ damage.
For example, cardiogenic shock can lead to:
- brain damage
- liver or kidney failure
- heart attack
Permanent organ damage can lead to death.
Preventing the occurrence of its root causes is key to preventing cardiogenic shock. This includes prevention and treatment of:
- high blood pressure
- high cholesterol
Here are some tips to follow:
- Seek immediate medical attention if you’re having any symptoms that may reflect a heart attack.
- If you have a previous history of heart attack, your doctor may prescribe medications that keep the heart strong or help it recover after a heart attack.
- If you have high blood pressure or a history of heart attack, work with your doctor to manage your blood pressure.
- Exercise regularly to manage your weight.
- Eat a healthy diet to help manage your cholesterol levels.
- If you smoke, quit. Here’s how to quit cold turkey.
Most importantly, call 911 or visit an emergency room immediately if you experience a heart attack or any of the symptoms associated with cardiogenic shock.
Doctors can help prevent cardiogenic shock, but only if you get the medical attention you need.