Cardiogenic Shock

Question 1

What is cardiogenic shock?

Answer 1

Loss of cardiac output due to reduced contractility rather than reduced preload, thus systemic vascular resistance increases to compensate

Question 2

How do you calculate cardiac output?

Answer 2

Stroke volume x Heart rate =cardiac output

Question 3

What is the presentation of cardiogenic shock?

Answer 3

• Chest pain
• Cold clammy peripheries
• Slow cap refil >2s
• Increased JVP (SVR compensating)
• Brady or Tachycardia
• Hypotensive
• Pulmonary oedeam signs in Left heart failure
• Right heart failure signs

Question 4

What are the different causes of cardiogenic shock?

Answer 4

!*Ischaemic heart disease: ACS, MI

• Acute dysrhthmia
• Cardiac injury due to direct trauma

Question 5

What is the management of cardiogenic shock?

Answer 5

1. A-E assessment
2. Supportive:
   >Oxygen 15L
   >IV Fluid challenge 250ml in heart failure
   >Analgesia
3. Treat underlying cause:
   >MI STEMI/NSTEMI
   >Cardiovert arrhythmias

Question 6

What investigations should be done in cardiogenic shock?

Answer 6

• ECG
• Bloods: trop
• Echo: assess pericardial fluid or direct myocardial injury