Cardiogenic Shock

Occurs when either systolic or

diastolic dysfunction of the
hearts pumping action results
in reduced CO
o Hearts inability to pump
blood forward = systolic
dysfunction
Primarily affects the left
ventricle since systolic
pressure is greater on
the left side of the heart
When it effects the right
side of the heart, blood
flow through the
pulmonary circulation is
reduced
Most common cause of
systolic dysfunction = MI
Other causes:
cardiomyopathies,
blunt cardiac injury,
severe or systemic
HTN
o Hearts ineffective filling:
diastolic dysfunction
Clinical Manifestation
o Tachycardia
o Decreased BP
o Slow capillary refill
o Chest pain (may or may not
be present)
o Tachypnea
o Crackles

Hypovolemic
Shock0

Cyanosis
Rhonchi
Increased sodium and water
retention
o Decreased renal blood flow
o Decreased urine output
o Pallor
o Cool, clammy skin
o Decreased cerebral
perfusion
Anxiety
Confusion
Agitation
o Decreased bowel sounds
o N/V
o Low CO
Diagnostic Findings
o Elevated cardiac markers
o Elevated b-Type natriuretic
peptide (BNP)
o Elevated blood glucose
o Elevated BUN
o ECG may show infarction or
dysrhythmia causing shock
o Echocardiogram to test for
underlying cardiac cause
(left ventricular dysfunction,
systolic dysfunction)
o CXR to look for pulmonary
infiltrates, pulmonary
edema)
o
o
o

Primary ventricular ischemia

Structural problems

Systolic dysfunction: ineffective forward movement of blood

Dysrhythmias

Diastolic dysfunction: ineffective filling

Increased pulmonary pressures

Decreased stroke volume

Decreased CO

Pulmonary edema

Decreased oxygenation
Decreased oxygen supply

Decreased tissue perfusion

Impaired cellular metabolism