Cardiogenic Shock

Question 1

What is cardiogenic shock?

Answer 1

• decreased CO –> cxing less perfusion even though there is circulation happening
• WORSE manifestation of decompesnated HF

Question 2

What cx cardiogenic shock?

Answer 2

• Acute MI and ischemia is the MOST COMMON
• -STEMI&raquo_space; non STEMI
• • LV HF –> pulm edema
• structural prob:
• • pericarditis, myocarditis, tamponade

Question 3

What is the leading cx of death in PATIENTS?

Answer 3

MI + Cardiogenic shock

mortality rates: 50%; first 48 hrs

Question 4

Mortality of cardiogenic shock?

Answer 4

40-80% w/in 1 month

Question 5

What is happening in cardiogenic shock?

Answer 5

pump failure –> less CO and BP –> less coronary artery perfusion –> less contractility and CO

Question 6

RF?

Answer 6

• older
• female
• Hx of MI
• CHF
• vessel dz
• diabetes

Question 7

What would you find?

Answer 7

-hypotension: systolic apnea–> hyperventilation) ; tachypnea

Question 8

Tx?

Answer 8

• DO NOT delay tx for Hx and PE
• MONAB
• IV access
• Meds:
• -1) vaspressors (norepi/dopamine) + inotrope (dobutamine)
• • 2) small fluids (challenge)