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CARDIOGENIC SHOCK

By: Rhodeva Braga






Sometimes called PUMP FAILURE
A condition wherein there is diminished
cardiac output that severely impairs tissue
perfusion.
Occurs when the hearts ability to contract
and pump blood is impaired and the supply
of oxygen is inadequate for the heart and
tissues.
2 causes of cardiogenic shock
CORONARY
NON-CORONARY
PATHOPHYSIOLOGY
dysrhythmia
Severe hypoxemia
Cardiac tamponade
Hypocalcemia
Cardiomyopathy
Drug toxicity
Myocardial infarction
Cardiac output is compromised
BP falls, tissue perfusion is reduced
Impaired tissue perfusion
Weakened heart
Impaired ability to pump
Ventricle does not fully eject its volume
of blood
Fluid accumulates in the lungs
Patients in cardiogenic shock may experience the pain of angina,
develop dysrhythmias, complain of fatigue, express feelings of
doom, and show signs of hemodynamic instability.
Signs and symptoms:
Rapid breathing
Severe shortness of
breath
Sudden, rapid heartbeat
(tachycardia)
Confusion
Loss of consciousness or
fainting
Weak pulse
Sweating
Pale skin
Cold hands or feet
Urinating less than
normal or not at all

DIAGNOSIS
Auscultation
Pulmonary artery pressure monitoring (PAP)
Arterial Blood Gases
Electrocardiogram
Enzyme levels
Coronary catheterization
MEDICAL MANAGEMENT
GOAL
To limit further myocardial damage
To Preserve the healthy myocardium
To improve the cardiac function
Increase oxygen supply to the heart muscle
INITIATION OF FIRST LINE
TREATMENT
OXYGENATION- nasal cannula at 2-6 L/min
-monitor ABG values and PULSE
OXIMETRY values
PAIN CONTROL- IV morphine
HEMODYNAMIC MONITORING
LABORATORY MARKER MONITORING- BNP, CK-
MB, ECG monitoring
PHARMACOLOGIC TREATMENT
DOBUTAMINE
Enhances the strength of cardiac
contraction, improving stroke
volume ejection and overall
cardiac output.

NITROGLYCERINE
Acts as a vasodilator (low dose)
Causes arterial vasodilation at higher
dose
In combination with dobutamine, it
increases cardiac output while
minimizing cardiac workload
DOPAMINE
May be used with dobutamine and
nitroglycerin to improve tissue perfusion.
OTHER MEDICATIONS:
Diuretics
Antiarrhythmic medications
Mechanical assistive devices
NURSING MANAGEMENT
Prevent cardiogenic shock
Monitor hemodynamic status
Administer medications and iv fluids
Enhancing safety and comfort
STATISTICS
CARDIOVASCULAR DISEASES
An estimated 17.3 million people died from
CVDs in 2008, representing 30% of all global
deaths. Of these deaths, an estimated 7.3
million were due to coronary heart disease
and 6.2 million were due to stroke .
Low- and middle-income countries are
disproportionally affected: over 80% of CVD
deaths take place in low- and middle-income
countries and occur almost equally in men
and women .
- WHO
The number of people who die from CVDs,
mainly from heart disease and stroke, will
increase to reach 23.3. million by 2030. CVDs
are projected to remain the single leading
cause of death.
Most cardiovascular diseases can be
prevented by addressing risk factors such as
tobacco use, unhealthy diet and obesity,
physical inactivity, high blood pressure,
diabetes and raised lipids.

NEWS AND TRENDS
The theme for World Health Day in 2013
is high blood pressure, also known as
raised blood pressure or hypertension. It
increases the risk of heart attacks,
strokes and kidney failure and if left
uncontrolled, high blood pressure can
also cause blindness, irregular heartbeat
and heart failure.
NEWS AND TRENDS
High blood pressure is preventable, and can
be countered by reducing salt intake, eating a
balanced diet, avoiding the harmful use of
alcohol, taking regular physical activity,
maintaining a healthy body weight and
avoiding tobacco use.
On 7 April 2013, World Health Day, activities
and campaigns throughout the world will
focus on the causes and consequences of high
blood pressure.

THANK YOU FOR
LISTENING!!!