What is Cardiogenic Shock? Causes, Diagnosis, Treatment

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What is Cardiogenic Shock? Causes,Diagnosis,Treatment

Cardiogenic shock or cardiac shock is a life-threatening medical emergency that develops when your heart is unable to pump enough blood and oxygen to the brain and other vital body organs.

Cardiogenic shock normally occurs as a result of a severe heart attack, but not everyone who gets a heart attack develops a cardiogenic shock. Cardiac shock can also occur as a result of an abnormal heart rhythm, progression of a congestive heart failure condition, a viral infection, or the blockage of a lung artery due to a blood clot.

Understand the signs of this dangerous condition, as prompt identification and treatment with modern therapies can help save your life.

In this article, we will be discussing in detail the causes, symptoms, diagnosis, treatment, and ways to prevent cardiogenic shock.

• What are the causes of cardiac shock?

• What are the risk factors for cardiac shock?

• What are the symptoms of cardiac shock?

• How to diagnose cardiac shock?

• What is the treatment for cardiac shock?

• How to prevent cardiac shock?

What are the causes of cardiac shock?

The most common cause of a cardiogenic shock is a heart attack. A severe heart attack can damage the left lower chamber of the heart (left ventricle), which is the main pumping chamber of the heart. This prevents the flow of oxygen-rich blood to that portion of the heart, leading to the weakening of the heart muscle and a cardiac shock.

Sometimes, damage to the right ventricle of the heart, which sends blood to the lungs to get oxygen, can cause a cardiogenic shock.

The causes of a cardiogenic shock may include the following:

• Damaged heart muscle due to a heart attack
• Myocarditis (heart muscle inflammation)
• Endocarditis (infection of the heart’s inner lining and valves)
• Arrhythmia (abnormal heart rhythm)
• Cardiac tamponade (excessive blood or fluid collection around the heart)
• Pulmonary embolism (The sudden blockage of a blood vessel in the lung by a blood clot) ( Know more about- What is Pulmonary Embolism ? )
• Heart failure
• Chest injury
• Problems associated with the heart valve
• Damage to the septum dividing the right and left ventricles of the heart

What are the risk factors for cardiac shock?

Some factors can increase the risk of having a cardiogenic shock. These factors include the following:

• Increased age
• More common in women than men
• More common in certain races like Asian Americans and Pacific Islanders
• History of heart problems such as heart attack and heart failure
• Diabetes ( Know more about- What is Diabetes? )
• Obesity
• History of heart bypass surgery ( Know more about- Cost of heart bypass surgery in Mumbai )
• Pneumothorax (a pleural disorder that may lead to a collapsed lung)
• Sepsis (inflammatory response to an infection which could be life-threatening)

What are the symptoms of cardiogenic shock?

The symptoms of cardiac shock include the following:

• Severe shortness of breath
• Rapid breathing
• Tachycardia (sudden and rapid heartbeat)
• Weak pulse
• Loss of consciousness
• Hypotension (low blood pressure)
• Pale skin
• Sweating
• Cold hands and feet
• Less or no urination

Since cardiac shock normally develops due to a heart attack, it is common to experience the symptoms of a heart attack while having a cardiogenic shock. 

These symptoms include the following:

• Fullness, pressure, or squeezing pain in the chest region
• Pain that spreads to the shoulder, one or both the arms, back, teeth, or jaw
• Shortness of breath
• Increasing episodes of chest pain
• Profuse sweating
• Nausea
• Vomiting
• Sudden dizziness or lightheadedness

( Know more about- What is a Heart Attack? )

How to diagnose cardiac shock?

A cardiac shock is usually diagnosed during an emergency. The doctor will check for the symptoms the patient is having and will then recommend a few tests to confirm the diagnosis. These tests include the following:

• Blood pressure measurement: The blood pressure will be reduced in a cardiogenic shock.
• Electrocardiogram or ECG: This is a non-invasive test performed to record the electrical activity of the heart using electrodes attached to the skin.
• Echocardiogram: This test uses sound waves to produce an image of the heart. The test helps in checking for heart damage due to a heart attack.
• Blood tests: This test helps the doctor check for infection, organ damage, and a heart attack. An arterial blood gas test may be performed to measure the oxygen level in the blood.
• Chest X-ray: This test helps the doctor view the shape and size of the heart and if there is fluid present in the lungs.
• Angiogram or cardiac catheterization: This test helps check for any narrowed or blocked arteries. A long, thin tube, known as a catheter, is inserted by the doctor through an artery in the leg or wrist and guided to the heart. A dye is then allowed to flow through the catheter to make the arteries more visible on the X-ray.

What is the treatment for cardiac shock?

Cardiac shock treatment aims to quickly restore the blood pressure and heart function of the patient. This involves giving several types of immediate treatments to the patient in the ambulance or emergency department. 

The different types of treatments given include the following:

Emergency, short-term treatments

A patient with suspected cardiac shock brought into the emergency room is immediately given oxygen via a mask or tube, breathing assistance using a ventilator, and intravenous or IV medications and fluids to support heart function and blood pressure.

Depending on the possible cause of cardiac shock, some drugs may be given by the doctor, including the following:

• Clot-busting drugs, like tissue plasminogen activator (tPA) to dissolve the coronary artery clots

• Anti Clotting medicines, like aspirin, heparin, or clopidogrel to prevent new clo formation

• Nitroglycerin for widening and relaxing the blood vessels

• Medicines like dopamine, dobutamine, or norepinephrine to increase the pumping ability of the heart

• Medications to relieve anxiety, regulate heart rhythm, and reduce the workload of the heart

If medications fail to stabilize the patient’s condition, the doctor may recommend a support device to temporarily take over the job of pumping blood and restore proper blood flow while giving the heart time to recover. 

These devices do not require invasive surgery and may include the following:

• Intra-aortic balloon pump: A small balloon is placed in the main artery of the heart, known as the aortic artery, using a flexible, thin tube known as a catheter. The balloon is inflated and deflated to move the blood coming from the heart.
• Extracorporeal membrane oxygenation or ECMO: This is an external device used to pump and oxygenate the blood, allowing the heart and lungs to rest.
• Impella heart pump: This is a small pump delivered via a catheter that is threaded through an artery. It is implanted in the heart’s left side. The pump draws the oxygenated blood from the heart and then pushes out the blood to the body.

Long-term treatments

After determining the cause of cardiac shock, the doctor may recommend different types of treatments to treat the underlying cause of the condition.

• To treat an abnormal heart rhythm, treatment options may include:

• Cardioversion: Medicines or a brief electric shock help reset the heart and restore a normal heartbeat.
• Pacemaker: This is a small electrical device implanted under the skin and connected by wires to the heart to regulate the heartbeats.
• Catheter ablation: This is a minimally invasive type of procedure performed to disrupt the electrical pathways that cause the heart to beat irregularly or too fast.( Know more about- What is Cardiac Ablation ? )

• To treat a coronary artery blockage, treatment options may include:

• Coronary bypass surgery: This procedure is performed to create a new route allowing the blood to flow around the blocked or narrowed artery.
• Percutaneous coronary interventions: These are minimally invasive procedures performed to open a blocked artery to restore blood flow using catheters.

To treat an advanced heart failure or a heart defect, more extensive treatments may be needed. Treatment options may include:

• Surgery to replace or repair heart valve ( Know more about- What is Heart Valve Replacement Surgery ? )

• Angioplasty and stent placement: A balloon is inserted through a catheter to the site of the blocked artery and the balloon is then inflated to open the artery. A stent is then placed there to keep the artery open.

• • Mechanical circulatory support: These are devices that assist the heart in its pumping action

• Heart transplantation

How to prevent cardiac shock?

Making healthy lifestyle choices to keep the heart healthy and blood pressure in check helps in preventing a cardiac shock. This can be done in the following ways:

• Quit smoking
• Maintain a healthy weight
• Reduce your salt consumption
• Avoid sugar consumption
• Avoid foods containing saturated fat ( Know more about- Diet Guide for Heart Patients )
• Limit alcohol consumption
• Exercise regularly

We hope that we were able to answer all your questions regarding cardiac shock through this article.

If you want more information about cardiogenic shock, you can contact a good Cardiologist.

We only aim to give you information through the article and do not recommend any medication or treatment in any way. Only a qualified doctor can give you the best advice and correct treatment plan.