Cardiogenic shock

Definition

Cardiogenic shock takes place when the heart is unable to supply enough blood and oxygen to the organs of the body.

Alternative Names

Shock - cardiogenic

Causes

The most common causes of cardiogenic shock 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 supply as much blood as the body needs. It can happen even if there hasn't been a heart attack. For example, if one of these problems listed above occurs and your heart function drops suddenly. Or if a valve becomes obstructed or if a combination of problems occurs.

Symptoms

Symptoms include:

Exams and Tests

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.

Tests include:

Other tests may be done to find out why the heart is not working properly.

Lab tests include:

Treatment

Cardiogenic shock is a medical emergency. You will need to stay in the hospital, most often in the Intensive or Coronary 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:

Outlook (Prognosis)

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.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Go to the emergency room or call 911 or the local emergency number if you have symptoms of cardiogenic shock. Cardiogenic shock is a medical emergency.

Prevention

You may reduce the risk for developing cardiogenic shock by:

References

Felker GM, Teerlink JR. Diagnosis and management of acute heart failure. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 49.

McMurray JJV, Pfeffer MA. Heart failure: treatment and prognosis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024: chap 46.

Rogers JG, O'Connor CM. Heart failure: epidemiology, pathobiology, and diagnosis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024: chap 45.


Review Date: 5/27/2024
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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