Cardiogenic shock

Question 1

when should fluids be administered

Answer 1

Administer 0.9% sodium chloride IV if there are signs of poor perfusion, provided the patient has no signs or symptoms of pulmonary oedema and the primary problem is not dysrhythmia

Question 2

when is meteraminol administered in cardiogenic shock

Answer 2

if the systolic blood pressure is less than 100 mmHg

Question 2

name some causes of cariogenic shock

Answer 2

ū The most common cause is acute myocardial infarction.
ū Other causes include acute valve rupture, pulmonary embolism,
dysrhythmia (particularly VT), cardiac tamponade and myocarditis.
ū Commonly the patient will be pale, cold and tachycardic with signs and
symptoms of pulmonary oedema.

Question 2

what causes cariogenic shock

Answer 2

the heart being unable to pump adequately:

Question 2

Cardiogenic shock secondary to poor right ventricular function characteristics

Answer 2

• Occasionally cardiogenic shock is caused by inadequate right ventricular function:
  ū The most common cause is an acute inferior myocardial infarction involving the right ventricle.
  ū Shock is likely to respond to 0.9% sodium chloride IV.

Question 3

Metaraminol is the preferred vasopressor because

Answer 3

it does not increase myocardial oxygen consumption and is less likely to cause tachycardia and/or tachydysrhythmia than adrenaline.

Question 3

Cardiogenic shock secondary to poor left ventricular function charceterisitics

Answer 3

• The most common cause is an acute anterior, anteroseptal or anterolateral STEMI:
  ū This is commonly associated with the development of pulmonary oedema.
  ū Shock is unlikely to respond to 0.9% sodium chloride IV and this must be
  administered with caution as it may make pulmonary oedema worse.