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Cardiogenic Shock

Cardiogenic ShockMichael Liston Cardiogenic Shock (CS) is a clinical condition of inadequate tissue(end organ) perfusion due to cardiac dysfunction Hypotension (SBP < 80-90 mmHg) or MAP 30 mmHg below baseline Reduced cardiac index(< L/min per m2) < L/min per m2 with support Adequate or elevated filling pressuresDifferentiating types of Shock Etiology PCWP CO SVR SVO2 Hypovolemic v v ^ vCardiogenic ^ v ^ vSeptic v or = ^ v ^Prevalence Occurs in 5-8% of STEMI and of NonSTEMI 40,000-50,000 cases annually in the USMortality Current registries suggest a mortality rate of about 50% Historically rates quoted as high as 80-90% With early revascularization.

in some patients pulmonary edema due to decreased LV compliance and net redistribution of intravascular volume to the lungs-further decline in circulating intravascular volume with diuretic use could lead to hypotension and shock ... vasodilators (use lowest doses possible)

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