Monday, April 18, 2011

Cardiogenic Shock

Cardiogenic shock is the inability of the heart to pump enough blood to the organs of the body due to damage to the heart muscle, most often from a large myocardial infarction. Other causes of cardiogenic shock include cardiomyopathy, cardiac valve problems, ventricular outflow obstruction, and ventriculoseptal defects. To diagnose cardiogenic shock, a catheter (tube) may be placed in the pulmonary artery (right heart catheterization). Measurements often indicate that blood is backing up into the lungs and the heart is not pumping properly.

Because it is a type of shock in which there is insufficient supply of blood (perfusion) to heart tissue to meet the required demands for oxygen and nutrients, cardiogenic shock is a largely irreversible condition and as such is more often fatal than not. The condition involves increasingly more pervasive cell death from oxygen starvation (hypoxia) and nutrient starvation. 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 the patient's life. Medications may be needed to increase blood pressure and improve heart function, including dobutamine, epinephrine, dopamine, and norepinephrine. When a heart dysrhythmia is serious, urgent treatment may be needed to restore a normal heart rhythm; it may include electrical shock therapy (defibrillation or cardioversion), implanting a temporary pacemaker, medications given through a vein.