Cardiogenic shock

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Shock - cardiogenic

Cardiogenic shock is a medical emergency. Treatment requires hospitalization, usually in the Intensive Care Unit. The goal of treatment is to identify and treat the cause of shock in order to save your life.

Medications may be needed to increase blood pressure and improve heart function, including:

• Dobutamine
• Dopamine
• Epinephrine
• Norepinephrine

When a heart rhythm disturbance (dysrhythmia) is serious, urgent treatment may be needed to restore a normal heart rhythm. This may include:

• Electrical "shock" therapy (defibrillation or cardioversion)
• Implanting a temporary pacemaker
• Medications given through a vein (intravenous)

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You may receive pain medicine if necessary. Bed rest is recommended to reduce demands on the heart.

Receiving oxygen, either by a nasal tube or mask over the mouth, lowers the workload of the heart by reducing tissue demands for blood flow.

You may receive intravenous fluids, including blood and blood products, if needed.

Other treatments for shock may include:

• Cardiac catheterization with coronary angioplasty and stenting
• Heart monitoring, including hemodynamic monitoring, to guide treatment
• Heart surgery (coronary artery bypass surgery, heart valve replacement, left ventricular assist device)
• Intra-aortic balloon counterpulsation (IABP) to improve heart and blood vessel function
• Pacemaker

In the past, the death rate from cardiogenic shock ranged 80 - 90%. In more recent studies, this rate has decreased to 50 - 75%.

When cardiogenic shock is not treated, the outlook is poor.

• Brain damage
• Kidney damage
• Liver damage

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

Review Date: 05/14/2010
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).