Cardiogenic Shock

Diagnosis

Cardiogenic shock occurs when the heart cannot pump enough blood to meet the body’s needs, often due to a severe heart attack or heart failure. Diagnosis is usually made quickly in emergency settings.

Common diagnostic steps include:

• Physical examination: Checking for low blood pressure, rapid heartbeat, cool and clammy skin, and signs of poor organ perfusion

• Electrocardiogram (ECG or EKG): Identifies heart rhythm problems or heart attack

• Blood tests: Measure cardiac enzymes, lactate, and kidney/liver function

• Echocardiogram: Assesses heart pumping ability and structural abnormalities

• Chest X-ray: Detects fluid in the lungs or heart enlargement

• Hemodynamic monitoring: Invasive techniques like a pulmonary artery catheter may measure heart pressures and guide treatment

Early diagnosis is critical to prevent organ failure and improve survival.

Treatment

Cardiogenic shock is a medical emergency and requires rapid intervention. Treatment options may include:

• Medications:

  • Inotropes and vasopressors to strengthen heart contractions and maintain blood pressure

  • Diuretics to reduce fluid overload

• Oxygen therapy: To improve oxygen delivery to tissues

• Mechanical support devices:

  • Intra-aortic balloon pump (IABP)

  • Ventricular assist devices (VADs)

  • Extracorporeal membrane oxygenation (ECMO) in severe cases

• Revascularization procedures:

  • Angioplasty or stent placement to open blocked coronary arteries

  • Coronary artery bypass surgery (CABG) if needed

• Fluid management: Careful balancing