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cardiogenic shock

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Cardiogenic shock is the failure of the heart to pump enough blood to the major organs to support life.

What is going on in the body? 
Any process that interferes with the pumping action of the heart or causes severe injury to the heart can cause shock. Failure of the heart to pump enough blood to the major organs causes them to stop working. This is a medical emergency, as this condition can be rapidly fatal.

What are the signs and symptoms of the condition? 
The signs and symptoms are partly related to the organs that are failing. This condition can cause: Some symptoms and signs depend on the reason the heart is not pumping well. For example, the heart rate is usually fast, but the rate could be abnormally low in some cases.

What are the causes and risks of the condition? 
Any disease that affects the ability of the heart to function can cause this condition. Common causes include: What can be done to prevent the condition? 
A person with known heart disease should seek medical attention if his or her condition gets worse for any reason. Prompt medical attention may catch problems before shock occurs. Taking medications as prescribed can also prevent shock. Prevention of coronary artery disease is probably the best way to prevent this condition. Control of coronary risk factors such as high blood pressure, diabetes, smoking, and high cholesterol can help.

How is the condition diagnosed? 
Cardiogenic shock is generally diagnosed from the history and physical examination. Determining the underlying cause is very important, and will require further testing. For example, blood tests and a heart tracing, or ECG, may be done if a heart attack is suspected. Plain or special x-ray tests are also frequently done.

What are the long-term effects of the condition? 
If untreated, this condition usually causes death. If the person survives, the long-term effects depend on the cause and the speed of diagnosis and treatment. Permanent organ damage, especially to the kidney and brain, can occur.

What are the risks to others? 
There are no risks to others.

What are the treatments for the condition? 
The goal of medical therapy is to improve the heart's ability to pump. Treatment depends on the underlying cause of the shock. Many different medications and devices may be used to try to restore heart function and blood flow. Some of these include:
  • heart medications to help the heart pump more effectively, such as digitalis
  • heart assist devices, such as a pacemaker
  • medications to dissolve blood clots
  • medications to help open up, or dilate, certain blood vessels
  • adding or removing fluids, such as blood, water, or salt
  • oxygen therapy
  • a ventilator, or artificial breathing machine
  • surgery

What are the side effects of the treatments? 
All medications have possible side effects. Ventilators increase the risk of infection. Surgery can be associated with bleeding, infection, and in some cases, death.

What happens after treatment for the condition? 
If the person survives, aggressive treatment and close monitoring of the underlying disease is needed. In some people, a heart transplant may be needed to fix the underlying problem. Testing for any permanent organ damage is done.

How is the condition monitored? 
Results of blood tests and urine output are strictly monitored. Progress in the treatment of the underlying disease is also carefully monitored. X-rays and other tests may be required in some cases.

Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne

Last Updated: 03/09/2004
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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