What is Cardiogenic Shock?

Cardiogenic shock is a cardiac condition which happens when the heart is unable to pump enough blood to meet the body’s needs. The most common cause of cardiogenic shock is a heart attack, but it can also develop because of an abnormal heart rhythm, a viral infection, or progression of pre-existing congestive heart failure and a blood clot blocking an artery in the lungs. The risk of developing a cardiogenic shock can be tackled by alerting and acting instinctively at the first visible clinical sign.

 

Stages of cardiogenic shock

 

The cardiogenic shock progresses through four stages:

 

At risk (A): Presence of heart disease, such as heart attack or heart failure, without indications of shock

Beginning (B): Manifestation of low blood pressure or heart rate

Classic (C): Necessity for medicine or devices to help get blood to organs

Deteriorating (D): Lack of response to medicine or devices, causing the condition to worsen

Extremis (E): Cardiac arrest needing CPR, ventilator and defibrillator

 

Symptoms

 

The symptoms of cardiogenic shock may vary depending on the blood pressure of an individual. It may start with rapid breathing, and there may be a sudden loss of consciousness. The typical signs of cardiogenic shock include:

 

• Chest pain
• Weak or irregular pulse
• Confusion or not being alert
• Low blood pressure causing dizziness
• Fainting
• Peeing less than normal
• Cool hands and feet
• Pale skin
• Tiredness
• Agitation
• Light-headedness
• Trouble concentrating or confusion
• Not being alert
• Blotchy skin or pale skin

 

Causes

 

The most common reason for a cardiogenic shock is a heart attack. A severe heart attack can harm the main pumping chamber of the heart, known as the left ventricle. In such a case, the body can’t get enough oxygen-rich blood.

 

Some additional factors that can weaken the heart and may result in cardiogenic shock:

 

• Heart muscle damage from a heart attack
• Chest injury
• Inflammation of the heart muscle (myocarditis)
• Infection of the heart's inner lining and valves (endocarditis)
• Abnormal heart rhythm (arrhythmia)
• Pulmonary embolism (blood clot blocking a lung vessel)
• Cardiac tamponade (fluid or blood around the heart)
• Damage to the septum dividing the heart's chambers

 

How is cardiogenic shock diagnosed?

 

To start with, your doctor may collect your medical history and enquire about symptoms you’re experiencing that day or recently. A physical exam may also be done to find these signs of cardiogenic shock:

 

• An abnormal heart rhythm
• Low blood pressure
• A weak pulse
• Skin that feels cold and clammy

 

What tests can be done to evaluate cardiogenic shock?

 

There are various tests that can be used to find out the presence of cardiogenic shock. These tests include:

 

Blood tests: These tests may indicate if there are certain enzymes that show kidney or liver damage. High levels of certain heart muscle biochemicals (eg, CK, CK-MB, troponin, serum myoglobin) may suggest a heart attack.

 

Chest X-ray: It is a non-invasive test that captures the images of the lungs and heart, allowing the doctor to identify any issues that may be causing chest pain.

 

Electrocardiogram (ECG or EKG): In this test, electrodes are placed on the arms, legs, and chest, to detect and print the heart's electrical impulses, allowing a 10-second snapshot of heart movement right at that moment.

 

Left heart catheterization: This involves inserting a catheter through an artery in the leg, arm, or neck to check for blockages or to explore the inside of the heart.

 

Right heart catheterization: A catheter is inserted through a vein in the leg, arm or neck and guided to the right side of the heart to provide a closer look at the pulmonary artery, which delivers blood from the heart to the lungs.

Sources:
https://www.nhlbi.nih.gov/health/cardiogenic-shock
https://www.healthline.com/health/cardiogenic-shock