Cardiogenic shock takes place when the heart has been damaged so much that it is unable to supply enough blood and oxygen to the organs of the body.
Alternative Names
Shock - cardiogenic
Causes
The most common causes are serious heart conditions. Many of these occur during or after a heart attack (myocardial infarction). These complications include:
A large section of heart muscle that no longer moves well or does not move at all
Breaking open (rupture) of the heart muscle due to damage from the heart attack
Pressure on the heart due to a buildup of fluid around it (pericardial tamponade)
Tear or rupture of the muscles or tendons that support the heart valves, especially the mitral valve
Tear or rupture of the wall (septum) between the left and right ventricles (lower heart chambers)
Very slow heart rhythm (bradycardia) or problem with the electrical system of the heart (heart block)
Cardiogenic shock occurs when the heart is unable to pump as much blood as the body needs. It can happen even if there hasn't been a heart attack if one of these problems occurs and your heart function drops suddenly.
Low blood pressure (most often less than 90 systolic)
Blood pressure that drops more than 10 points when you stand up after lying down (orthostatic hypotension)
Weak (thready) pulse
Cold and clammy skin
To diagnose cardiogenic shock, a catheter (tube) may be placed in the lung artery (right heart catheterization). Tests may show that blood is backing up into the lungs and the heart is not pumping well.
Cardiogenic shock is a medical emergency. You will need to stay in the hospital, most often in the Intensive or Coronary Care Unit (ICU). The goal of treatment is to find and treat the cause of shock to save your life.
You may need medicines to increase blood pressure and improve heart function, including:
Dobutamine
Dopamine
Epinephrine
Levosimendan
Milrinone
Norepinephrine
Vasopressin
These medicines may help in the short-term. They are not often used for a long time.
When a heart rhythm disturbance (dysrhythmia) is serious, urgent treatment may be needed to restore a normal heart rhythm. This may include:
Electrical "shock" therapy (defibrillation or cardioversion)
Implanting a temporary pacemaker
Medicines given through a vein (IV)
You may also receive:
Pain medicine
Oxygen
Fluids, blood, and blood products through a vein (IV)
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of cardiogenic shock. Cardiogenic shock is a medical emergency.
Prevention
You may reduce the risk for developing cardiogenic shock by:
Quickly treating its cause (such as heart attack or heart valve problem)
Preventing and treating the risk factors for heart disease, such as diabetes, high blood pressure, high cholesterol and triglycerides, or tobacco use
References
Felker GM, Teerlink JR. Diagnosis and management of acute heart failure. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 49.
Review Date:
5/8/2022
Reviewed By:
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.