Shock - cardiogenic
Cardiogenic shock takes place when the heart has been damaged so much that it is unable to supply enough blood to the organs of the body.
The most common causes are serious heart conditions. Many of these occur during or after a heart attack (myocardial infarction). These complications include:
Cardiogenic shock occurs when the heart is unable to pump as much blood as the body needs. It can happen even if there hasn't been a heart attack if one of these problems occurs and your heart function drops suddenly.
An exam will show:
To diagnose cardiogenic shock, a catheter (tube) may be placed in the lung artery (right heart catheterization). Tests may show that blood is backing up into the lungs and the heart is not pumping well.
Other studies may be done to find out why the heart is not working properly.
Lab tests include:
Cardiogenic shock is a medical emergency. You will need to stay in the hospital, most often in the Intensive Care Unit (ICU). The goal of treatment is to find and treat the cause of shock to save your life.
You may need medicines to increase blood pressure and improve heart function, including:
These medicines may help in the short-term. They are not often used for a long time.
When a heart rhythm disturbance (dysrhythmia) is serious, urgent treatment may be needed to restore a normal heart rhythm. This may include:
You may also receive:
Other treatments for shock may include:
In the past, the death rate from cardiogenic shock ranged from 80% to 90%. In more recent studies, this rate has decreased to 50% to 75%.
When cardiogenic shock is not treated, the outlook is very poor.
Complications may include:
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of cardiogenic shock. Cardiogenic shock is a medical emergency.
You may reduce the risk of developing cardiogenic shock by:
Felker GM, Teerlink JR. Diagnosis and management of acute heart failure. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 24.
Hollenberg SM. Cardiogenic shock. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 99.BACK TO TOP
Review Date: 6/25/2020
Reviewed By: Micaela Iantorno, MD, MSc, FAHA, RPVI, Interventional Cardiologist at Mary Washington Hospital Center, Fredericksburg, VA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..
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