Cardiogenic shock occurs when the heart has been damaged so much that it 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. According to the National Institutes of Health, almost no one survived cardiogenic shock in the past. Today, more than 50 percent of people who experience cardiogenic shock survive. This is due to improved treatments and quicker recognition of symptoms.
However, the outlook is still very poor if cardiogenic shock is ignored and untreated. You should contact your doctor or call 911 immediately if you are experiencing any of the symptoms of this condition.
Signs and Symptoms
Symptoms of cardiogenic shock can appear very quickly. Symptoms may include the following:
- confusion and anxiety
- sweating and cold extremities (fingers and toes)
- rapid but weak heart beat (tachycardia)
- low or absent urinary output (oliguria)
- fatigue due to hyperventilation
- sudden shortness of breath
- coma, if measures are not taken in time to stop the shock
It is vital to call 911 or visit an emergency room immediately if you are 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:
- pulmonary embolism (sudden blockage of an artery in the lung)
- pericardial tamponade (fluid buildup around the heart reducing its filling capacity)
- sudden valvular regurgitation (damage to the valves allowing the backflow of blood)
- rupture of the wall of the heart (due to increased pressure)
- inability of heart muscle to work properly (or at all in some cases)
- ventricular fibrillation (an arrhythmia in which the lower chambers fibrillate or quiver)
- ventricular tachycardia (an arrhythmia where the ventricles beat too fast)
Drug overdoses can also affect your heart’s ability to pump blood and may lead to a cardiogenic shock.
Risk factors for cardiogenic shock include:
- previous history of myocardial infarction (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)
If you see someone suffering from a heart attack or believe you may be suffering 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 can be 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 if there has been serious damage to heart tissue. They can also tell if there has 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 arrhythmias (irregular heart rates) such as ventricular tachycardia or ventricular fibrillation. These may be cause of the cardiogenic shock. An ECG may also show a quickened pulse.
This ultrasound imaging of the structure and activity of the heart provides an image showing the flow of blood. 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.
This is a specialized pulmonary catheter that is inserted into the heart to show its pumping activity. 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. The doctor may also give medications and fluid to improve blood pressure and increase the amount of blood your heart pumps.
Preventing the occurrence of its root causes is the key to preventing cardiogenic shock. This includes hypertension, smoking, obesity, and high levels of cholesterol. If you have a previous history of heart attack, your doctor may prescribe medications that can help prevent cardiogenic shock.
People with hypertension or previous history of heart attack should keep their blood pressure under control and use medications as directed by their doctors. Obese people should exercise regularly and try to lose weight. People with high cholesterol should lower their intake of fat in their diet. Smokers should try to quit smoking. 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. Your doctors can help prevent cardiogenic shock, but only if you get the medical attention you need.