Cardiogenic shock occurs when the heart cannot pump blood to the brain and other key organs. It is a medical emergency that requires immediate treatment.
Cardiogenic shock can result from a heart attack or other issues of the heart. Quick treatment is necessary to avoid complications or death. Taking steps to boost heart health may help reduce the risk of cardiogenic shock.
Keep reading to learn more about cardiogenic shock, including the causes, symptoms, and treatment options.
Cardiogenic shock is a state that occurs suddenly when the heart cannot supply fresh blood — and, therefore, oxygen — to the brain and other organs.
Without blood and fresh oxygen reaching the organs and brain, the body goes into a state of shock. Cardiogenic shock is a medical emergency. Without immediate treatment, cardiogenic shock can be fatal.
Even with proper treatment, cardiogenic shock is still potentially fatal. Research in Open Heart notes that 25–50% of people who present with cardiogenic shock will die.
Part of the reason for this high mortality rate is that the shock state can act as a cycle of sorts. The initial damage leading to the shock causes the body to go into this state, which may then trigger more damage and further shock.
Swift treatment is necessary to avoid this cycle and help give the person the best chance of recovery.
The National Heart, Lung, and Blood Institute (NHLBI) state that a heart attack is the most common cause of cardiogenic shock but not the only cause. They note that other possible causes include:
- heart failure
- chest injuries
- certain medications, such as calcium channel blockers, although this is rare
- blood clots
- fluid buildup in the chest
- internal bleeding
- blood loss
- pulmonary embolism
- rare complications from procedures in the heart
Some people may have an increased risk of cardiogenic shock, including those who:
- are aged 75 years or over
- have underlying cardiovascular disease, such as atherosclerosis, heart failure, or ischemic valve disease
- have overweight or obesity
- have diabetes or prediabetes
- have lung disorders, such as pneumothorax
Cardiogenic shock is more common in males than in females. Furthermore, Asian American people and Pacific Islanders have a higher risk of cardiogenic shock than those belonging to other ethnic groups.
The symptoms of cardiogenic shock occur as a reaction to the loss of oxygen-rich blood in the body.
The symptoms that a person experiences may depend on how quickly the blood pressure drops and how low it gets. Some individuals may experience mild symptoms at first, whereas others may have no symptoms and then immediately lose consciousness.
Possible signs and symptoms include:
- a sudden drop in blood pressure
- slow heart rate
- bulging veins in the neck
- swollen feet
- pale, blue hue to the skin
- cold hands and feet
- sweaty skin
- loss of consciousness
- rapid breathing
If a person does not receive treatment, cardiogenic shock can cause life threatening complications, such as organ damage and complete organ failure. It can also be fatal in some cases.
Doctors will work quickly to make a diagnosis based on the person’s signs and symptoms while administering any treatments that they may need.
The diagnostic process will include an electrocardiogram (EKG) that shows the activity of the heart. Research in the Journal of the American Heart Association notes that doctors should order the EKG within 10 minutes of the person presenting. This test may reveal irregularities in the heart rhythm that could help doctors diagnose the cause.
Similarly, an echocardiogram can show an image of the heart to help doctors detect any areas of damage from a heart attack.
Other diagnostic tools will help once the person is stable. Doctors may recommend different blood tests within the first day, or even the first hours, of administering a person. The results of these tests may help confirm their diagnosis or change the course of treatment.
Cardiogenic shock is a medical emergency and requires immediate treatment. The aim of treatment is to restore blood flow to the brain and other organs as quickly as possible to protect them from damage.
Treatments may include heart procedures or other surgeries, depending on the person’s condition when treatment begins.
Treatments may include:
- intravenous fluids
- heart catheterization for coronary angiography
- oxygen supplementation
- mechanical ventilation
- mechanical circulatory support (MCS) devices
- medicines, such as vasopressors, to contract blood vessels and raise blood pressure
Other treatments may need to focus on preventing or treating damage to other organs.
For example, research suggests that acute kidney injury occurs in 13–28% of people with cardiogenic shock. These individuals may need additional treatments, such as dialysis or fluid replacement.
Even with modern advances, treatment is still challenging.
There are no guaranteed screening tests for cardiogenic shock. As the leading cause of cardiogenic shock is a heart attack, anyone experiencing the signs of a heart attack should seek emergency medical care immediately.
Additionally, lowering the risk of heart attack and heart disease may help reduce the likelihood of cardiogenic shock.
The NHLBI recommend steps that people can take to make their lifestyle more heart-healthy and reduce their risk of heart disease. These include:
- quitting smoking, if a smoker, or avoiding secondhand smoke
- limiting alcohol intake
- reaching or maintaining a moderate weight
- maintaining healthy blood pressure and cholesterol levels
- finding ways to manage stress, such as mindfulness, meditation, or deep breathing
- getting regular physical exercise
- getting 7–9 hours of sleep each night
- limiting certain foods, such as those high in sodium, saturated fats, and sugars
There is no guarantee that these factors will prevent every case of cardiogenic shock. Other issues, such as injury or complications from surgery, may lead to the issue. However, controlling dietary and lifestyle factors that affect the heart may reduce the risk as much as possible.
Cardiogenic shock is a medical emergency that occurs when the heart cannot provide oxygen-rich blood to the brain and other organs. It occurs most commonly due to heart attack or heart failure, but it can also be due to a complication from other conditions or procedures.
Prompt treatment of cardiogenic shock is crucial to give the person the best chance to survive and avoid damage to the organs or organ failure. Even with proper treatment, the risk of mortality is high.
Anyone noting sudden symptoms of cardiogenic shock or heart attack should contact the emergency medical services immediately.