Causes and risk factors
In cardiogenic shock the heart is unable to pump enough quantity of blood to the different parts of the body as a result of this decrease output the blood supply along with nutrients and oxygen supply to the body is reduced. This result in failure of the heart and over time also causes various organ failures. There are various conditions which causes this reduced blood supply to the heart. Myocardial infaction is the most common cause of this. Certain other conditions like left ventricular failure, infective endocarditis, viral myocarditis and various cardiomyopathies. Diseases affecting the arteries of the heart along with valvular affections are certain other conditions which can result into cardiogenic shock. Overdoses of certain drugs can also affect the blood pumping capacity of the heart.
Clinical presentation
As the blood pumped from the heart is reduced the blood supply along with the oxygen supply to the various parts of the body is reduced, hence the extremities become cold. The work load on the heart increases hence there occurs palpitation and rapid breathing is seen. This less blood supply hampers the functioning of the various organs specially the lungs and kidney. The urine output decreases. Shortness of breath, sweating and weak pulse along with confusion and loss of consciousness are the other symptoms seen. On examination low blood pressure, pale and clammy skin, sunken eyes are seen. There occurs a state of dehydration. This all can lead to permanent damage to the organs of the body and can also lead to death.
Investigations
Diagnosis is done on the basis of the symptoms narrated by the attendant. The vital signs of the patients are monitored. The following investigations and physical examination can also be done. On immediate basis complete blood count, urine analysis, ECG and Chest X ray, electrolyte levels and cardiac enzymes are done. Certain other investigations can also be advised by the doctor.
Treatment
Cardiogenic shock is a medical emergency and prompt treatment is needed to prevent complications and death. The patient is hospitalized and is kept under observation. Treatment of the underlying cause is necessary. Intravenous fluids are administered. Medications like aspirin, Inotropic agents, thromolytics etc are administered. If required surgical intervention is done e.g.: angioplasty, or stent implantation.
