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Clinical Manifestation:

Patients with cardiogenic shock may exhibit these manifestation which include:

• Breathing problems, including rapid breathing and severe shortness of breath
• Bulging of large veins in the neck
• Clammy skin
• Cold hands and feet
• Loss of consciousness
• Swelling of feet
• Urinating much less than usual or not at all.

Cause of cardiogenic shock:

The most common cause of cardiogenic shock is acute coronary syndrome, accounting for about 70% to 80% of
cardiogenic shock cases. Other causes of cardiogenic shock predominantly include the decompensation of
chronic heart failure and right ventricular failure in about 5% of cases [2]. Cardiogenic shock can be caused by
an acute cardiac condition or a systemic illness that triggers a chronic cardiac condition associated with minimal
cardiac reserve. Unstable angina, postcardiotomy syndrome, valvular heart disease, myocardial disease (such as
myo-carditis), LV outflow obstruction in hypertrophic cardiomyopathy, stress-induced cardiomyopathy,
pericardial tamponade, congenital lesions, and mechanical injury to the heart have all been implicated in the
pathogenesis of cardiogenic shock [3].

Treatment:

Cardiogenic shock is life-threatening and requires rapid diagnosis and identification of the cause, and
emergency medical treatment. Treatments include medicines, heart procedures, and medical devices to support
or restore blood flow in the body and prevent organ damage. Because cardiogenic shock is a serious medical
condition affecting multiple body organs, a team of medical specialists usually provides care. Some medical
devices may be used temporarily to stabilize or support until a permanent device can be implanted or until a
heart transplant can be performed. For people who have severe organ damage and may not survive after
cardiogenic shock, palliative care or hospice care may help them have a better quality of life with fewer
symptoms. [4].

References:

1. Rab T, Ratanapo S, Kern KB, Basir MB, McDaniel M, Meraj P, King SB, O'Neill W. Cardiac Shock Care Centers: JACC
Review Topic of the Week. J Am Coll Cardiol. 2018 Oct 16;72(16):1972-1980.
2. Klein T, Ramani GV. Assessment and management of cardiogenic shock in the emergency department. Cardiol Clin.
2012;30:651-664.
3. Ukor Ida-Fong, Hockings LE. Ischaemic cardiogenic shock. Anaesth Intensive Care Med. 2014;15:68-71.
4. Santucci A, Cavallini C. [Which role today for intra-aortic balloon counterpulsation?] G Ital Cardiol (Rome). 2018
Oct;19(10):533-541.
5. Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction
complicated by cardiogenic shock. SHOCK Investigators. Should We Emergently Revascularize
Occluded Coronaries for Cardiogenic Shock. N Engl J Med 1999;341:625–34. 4. Webb JG, Sleeper
LA, Buller CE, et al. Implications of the timing of onset of cardiogenic shock after acute myocardial
infarction: a report from the SHOCK Trial Registry. SHould we emergently revascularize Occluded
Coronaries for cardiogenic shocK? J Am Coll Cardiol 2000;36:1084–90.v
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