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What Is the Treatment for Cardiogenic Shock?

By Maggie J. Hall
Updated May 17, 2024
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Treatment for cardiogenic shock requires circulation restoration to ensure that adequate blood-rich oxygen travels to all areas of the body. Fluids, medication, device implants, and surgery are some of the techniques that hospital staff use to improve a patient's status and correct the underlying cause of the condition. Patients with symptoms of a possible heart attack or accompanying cardiogenic shock require immediate emergency medical assistance. The earlier that a patient receives treatment for cardiogenic shock, the better the chance for survival.

Signs of cardiogenic shock generally include a number of symptoms. Individuals begin sweating and exhibit pale skin. As circulation decreases, the hands and feet become cold. The heart rate may suddenly increase or become weak. Decreasing oxygen levels cause confusion and loss of consciousness, and in the absence blood and oxygen, the cells and tissues of the heart and other organs begin dying.

Cardiogenic shock occurs because the heart loses the ability to effectively pump blood through the body, depriving cells and tissues of nutrients and oxygen. Physicians refer to this deficiency, which often follows a myocardial infarction, or heart attack, as inadequate tissue perfusion. A heart attack disrupts cardiac rhythm, by impairing the heart's ability to contract, which causes a lack of proper circulation. Heart conditions that contribute to cardiogenic shock include blocked coronary arteries, heart infections, and blood or fluid surrounding and compressing the heart, weakening contractions and impairing circulation.

Emergency medical technicians or paramedics begin treatment for cardiogenic shock by administering supplemental oxygen and assessing vital signs. At the hospital, medical personnel insert intravenous or intra-arterial catheters for quick fluid and medication delivery. They also take electrocardiogram readings, monitor vital signs and oxygen levels, and keep the patient's airway open. Laboratory blood tests reveal possible acid/base or electrolyte imbalances, and blood tests determine if the heart is releasing enzymes that indicate tissue damage from a heart attack.

Diagnosing underlying conditions usually requires that a patient undergo imaging studies, which may include x-rays or electrocardiography studies to evaluate cardiac abnormalities and heart contractility. Cardiologists may also require that patients undergo cardiac catheterization to locate vascular blockages. Physicians may use clot-busting medications, intra-aortic balloon pumps, or left ventricular assist devices, which mimic the pumping action of the heart.

A patient may require surgical intervention as part of treatment for cardiogenic shock. Cell and tissue death from oxygen deprivation may require valve repair or replacement. Cardiac surgeries can also correct ruptures in the walls between the ventricles. Weakening of this wall diminishes the action of the left ventricle. Patients with damaged cardiac arteries usually require coronary artery bypass grafts.

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