Cardiogenic Shock

Cardiogenic Shock

1. Pump failure resulting in inability of heart to eject sufficient blood to keep tissues/organs oxygenated

   • Myocardial Injury (acute or progressive)
     • ▼ Contractility
       • ▼ Tissue perfusion
         • Compensatory mechanisms are activated
           • SNS Stimulation
           • Renin-angiotensin-aldosterone system
           • ADH release
           • Intracellular fluid shift
           • Massive vasoconstriction
             • ▼ Perfusion of vital organs
               • Multisystem organ failure
       • ▼ BP
       • ▼ Pulmonary edema

2. The goal is to fix the following: Preload (if decreased, administer fluids/if increased, administer diuretics), Afterload (if decreased administer vasopressors, if increased administer vasodilators), contractility (Dopamine, IABP, nitro, MS, beta blockers, external pacing)