What is cardiogenic shock?

Shock is a condition in which the blood pressure is very low and the body does not get all the blood it needs. Shock can happen when you suddenly lose a lot of blood, you have a severe allergic reaction, or your heart is not pumping well. When low blood pressure happens because the heart is not pumping well, the problem is called cardiogenic shock.

Shock is an emergency and requires medical care right away. Untreated shock usually causes death.

What is the cause?

The main cause of cardiogenic shock is a heart attack. A heart attack happens when the heart muscle does not get enough blood and oxygen. The lack of blood makes the heart muscle weak. Sometimes part of the muscle dies. If the muscle is hurt, the heart cannot pump blood very well.

What are the symptoms?

When you are in shock and your blood pressure is very low, symptoms may include:

• Extreme weakness
• Sweating
• Pale skin color
• Cold hands and feet
• Less urine
• Nausea
• Fast, shallow breathing
• Fainting (loss of consciousness)

If the damage caused by a heart attack is bad, the signs and symptoms of cardiogenic shock may show up right away. If the heart attack is less severe, shock may not happen for several hours.

How is it diagnosed?

Your healthcare provider will review your medical history, examine you, and measure your blood pressure. You may have the following tests:

• A heart monitor can show abnormal heart rates or rhythms.
• An ECG (electrocardiogram) measures and records the electrical activity of your heart. It gives early information about areas of heart muscle that are damaged.
• Your blood oxygen level can be monitored by a sensor attached to your finger or ear.
• Blood tests may be done to check for damage to the heart, kidneys, or liver and other problems.
• A chest X-ray can show abnormal heart size and signs of heart failure (poor pumping by the heart).
• An ultrasound scan called an echocardiogram uses sound waves and their echoes passed through your body from a small device held against your skin. The sound waves make pictures of the inside of the heart to look at the heart valves, blood flow, and how well the heart muscle is pumping.
• A coronary angiogram (heart catheterization) uses X-rays, dye injected into a vein, and a small tube called a catheter inserted into a blood vessel to look at your blood vessels and heart.

How is it treated?

Cardiogenic shock is treated by medical staff in an emergency room or in the hospital’s intensive care unit.

When a heart attack causes shock, treatment includes medicines to:

• Restore blood flow to the damaged part of the heart muscle.
• Raise blood pressure.

Medicine may not be enough to treat the shock. The heart muscle may need help pumping. Mechanical devices such as an intra-aortic balloon pump (IABP) may be used for a short time. IABP helps the heart so it doesn’t have to work as hard and increases blood flow to the heart and the rest of the body.

How can I prevent cardiogenic shock?

Call 911 for emergency help right away if you have the following symptoms of a possible heart attack:

• You have chest discomfort that lasts for more than 5 minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or burning.
• You have chest discomfort with lightheadedness.
• You have chest pain that goes beyond your chest to one or both arms, neck, jaw, shoulder, back, or stomach.
• You have trouble breathing, with or without chest pain.
• You have chest discomfort along with sweating, indigestion, vomiting, or feeling sick to your stomach.