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Cardiogenic shock
Classification and external resources
ICD-10 R57.0
ICD-9 785.51
DiseasesDB 29216
MedlinePlus 000185
eMedicine med/285 
MeSH D012770

Cardiogenic shock is based upon an inadequate circulation of blood due to primary failure of the ventricles of the heart to function effectively. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings R00-R69 - Symptoms and Signs (R00-R09 Circulatory and Respiratory systems ( Abnormalities of Heart beat The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells such as nutrients and oxygen—and transports Waste products In the Heart, a ventricle is a heart chamber which collects Blood from an atrium (another heart chamber that is smaller than a ventricle and The heart is a muscular organ in all Vertebrates responsible for pumping Blood through the Blood vessels by repeated rhythmic [1] [2] [3] [4] [5]

Since this is a category of shock there is insufficient perfusion of tissue (i. In Physiology, perfusion is the process of nutritive delivery of Arterial Blood to a Capillary bed in the Biological tissue. Tissue is a cellular organizational level intermediate between cells and a complete organism e. the heart) to meet the required demand for oxygen and nutrients. The heart is a muscular organ in all Vertebrates responsible for pumping Blood through the Blood vessels by repeated rhythmic Oxygen (from the Greek roots ὀξύς (oxys (acid literally "sharp" from the taste of acids and -γενής (-genēs (producer literally begetteris the A nutrient is food or chemicals that an organism needs to live and grow or a substance used in an organism's metabolism which must be taken in from its environment This leads to cell death from oxygen starvation, hypoxia. The cell is the structural and functional unit of all known living Organisms It is the smallest unit of an organism that is classified as living and is often called Oxygen (from the Greek roots ὀξύς (oxys (acid literally "sharp" from the taste of acids and -γενής (-genēs (producer literally begetteris the Chronic Hypoxia is a pathological condition in which the body as a whole ( generalized hypoxia) or region of the body ( tissue hypoxia) is deprived of adequate Because of this it may lead to cardiac arrest (or circulatory arrest) which is an acute cessation of cardiac pump function. A cardiac arrest, also known as cardiorespiratory arrest, cardiopulmonary arrest or circulatory arrest, is the abrupt cessation of normal circulation of [4]


Cardiogenic shock is defined by sustained hypotension with tissue hypoperfusion despite adequate left ventricular filling pressure. Signs of tissue hypoperfusion include oliguria (<30 mL/h), cool extremities, and altered mentation.

Contents

Etiology

Cardiogenic shock is caused by the failure of the heart to pump effectively. It can be due to damage to the heart muscle, most often from a large myocardial infarction. The heart is a muscular organ in all Vertebrates responsible for pumping Blood through the Blood vessels by repeated rhythmic Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply Other causes include arrhythmia, cardiomyopathy, cardiac valve problems, ventricular outflow obstruction (i. Dysrhythmia redirects here For the American band see Dysrhythmia (band. Cardiomyopathy, which literally means "heart muscle disease" is the deterioration of the function of the Myocardium (i In Anatomy, the heart valves are Valves in the Heart that maintain the unidirectional flow of blood by opening and closing depending on the difference e. aortic valve stenosis, aortic dissection, systolic anterior motion (SAM) in hypertrophic cardiomyopathy), ventriculoseptal defects or medical error. Hypertrophic cardiomyopathy, or HCM, is a disease of the Myocardium (the Muscle of the Heart) in which a portion of the myocardium is [1] [2] [4] [3] [5] [6] [7]

Signs and symptoms

Diagnosis

Electrocardiogram

An electrocardiogram helps establishing the exact diagnosis and guides treatment, it may reveal:

Radiology

Echocardiography may show arrhythmia, signs of PED, ventricular septal rupture (VSR), an obstructed outflow tract or cardiomyopathy. Dysrhythmia redirects here For the American band see Dysrhythmia (band. Cardiomyopathy, which literally means "heart muscle disease" is the deterioration of the function of the Myocardium (i An echocardiogram is a Sonography of the Heart. Also known as a cardiac ultrasound it uses standard ultrasound techniques to image two-dimensional slices of

Swan-ganz catheter

The Swan-ganz catheter or Pulmonary artery catheter may assist in the diagnosis by providing information on the hemodynamics. In Medicine pulmonary artery catheterization (PAC is the insertion of a Catheter into a Pulmonary artery.

Biopsy

In case of suspected cardiomyopathy a biopsy of heart muscle may be needed to make a definite diagnosis. A biopsy (in Greek: βίος life and όψη look/appearance is a Medical test involving the removal of cells or tissues Diagnosis is the identification by Process of elimination, of the nature of anything

Treatment

In cardiogenic shock: depending on the type of myocardal infarction one can infuse fluids or in shock refractory to infusing fluids inotropica. An inotrope (ˈaɪnətroʊp is an agent that alters the force or energy of Muscular contractions Negatively inotropic agents weaken the force of muscular contractions In case of cardiac arrhythmia several anti-arrhythmic agents may be administered, i. Dysrhythmia redirects here For the American band see Dysrhythmia (band. e. adenosine, verapamil, amiodarone, β-blocker. Adenosine is a Nucleoside composed of a Molecule of Adenine attached to a Ribose sugar molecule ( Ribofuranose) moiety via a β-N9- Verapamil (brand names Isoptin, Verelan, Calan, Bosoptin, Covera-HS) is an L-type Calcium channel blocker. Amiodarone is an Antiarrhythmic agent (medication used for irregular heart beat used for various types of tachyarrhythmias (fast forms of irregular heart beat both ventricular Beta blockers (sometimes written as β-blocker) are a class of drugs used for various indications but particularly for the management of Cardiac arrhythmias Positive inotropic agents, which enhance the heart's pumping capabilities, are used to improve the contractility and correct the hypotension. An inotrope (ˈaɪnətroʊp is an agent that alters the force or energy of Muscular contractions Negatively inotropic agents weaken the force of muscular contractions Should that not suffice an intra-aortic balloon pump (which reduces workload for the heart, and improves perfusion of the coronary arteries) can be considered or a left ventricular assist device (which augments the pump-function of the heart). The Intra-aortic balloon pump (IABP is a mechanical device that is used to decrease myocardial oxygen demand while at the same time increasing Cardiac output. In cardiac Physiology, afterload is used to mean the tension produced by a chamber of the Heart in order to contract. Coronary circulation is the circulation of blood in the Blood vessels that supply Blood to and from the Heart muscle A Ventricular assist device, or VAD, is a mechanical device that is used to partially or completely replace the function of a failing Heart. [1] [2] [3]

Cardiogenic shock may be treated with intravenous dobutamine, which acts on β1 receptors of the heart which causes increased power and heart rate. Dobutamine is a Sympathomimetic Drug used in the treatment of Heart failure and Cardiogenic shock. [8]

Notes

  1. ^ a b c Irwin and Rippe's Intensive Care Medicine by Irwin and Rippe, Fifth Edition (2003), Lippincott Williams & Wilkins, ISBN 0-7817-3548-3
  2. ^ a b c The ICU Book by Paul Marino MD, PhD, Second Edition (1997), Lippincott Williams & Wilkins, ISBN 0-683-05565-8
  3. ^ a b c Fundamental Critical Care Support, A standardized curriculum of Critical Care by the Society of Critical Care Medicine
  4. ^ a b c Textbooks of Internal Medicine
    • Harrison's Principles of Internal Medicine 16th Edition, The McGraw-Hill Companies, ISBN 0-07-140235-7
    • Cecil Textbook of Medicine by Lee Goldman, Dennis Ausiello, 22nd Edition (2003), W. Lippincott Williams & Wilkins is an academic and professional medical publisher founded in 1792 and now a part of the Wolters Kluwer group Lippincott Williams & Wilkins is an academic and professional medical publisher founded in 1792 and now a part of the Wolters Kluwer group Society of Critical Care Medicine ( SCCM) established in 1970 is an independently incorporated international educational and scientific society serving its 14000 members The McGraw-Hill Companies Inc, ( is a Publicly traded corporation headquartered in Rockefeller Center in New York City. B. Saunders Company, ISBN 0-7216-9652-X
    • The Oxford Textbook of Medicine Edited by David A. Warrell, Timothy M. Cox and John D. Firth with Edward J. Benz, Fourth Edition (2003), Oxford University Press, ISBN 0-19-262922-0
  5. ^ a b Shock: An Overview PDF by Michael L. Cheatham, MD, Ernest F. J. Block, MD, Howard G. Smith, MD, John T. Promes, MD, Surgical Critical Care Service, Department of Surgical Education, Orlando Regional Medical Center Orlando, Florida
  6. ^ Cardiogenic shock Department of Anaesthesia and Intensive Care of The Chinese University of Hong Kong
  7. ^ Introduction to management of shock for junior ICU trainees and medical students Department of Anaesthesia and Intensive Care of The Chinese University of Hong Kong
  8. ^ Rang and Dale's Pharmacology, H. Orlando Regional Medical Center (ORMC a 581-bed hospital in downtown Orlando specializes in trauma critical care emergency care cardiology orthopedics and neurosciences Orlando is a major City in central Florida, USA and is the County seat of Orange County Florida. Hong Kong ( officially the Hong Kong Special Administrative Region, is a territory located on China 's south coast on the Pearl River Delta, and borders Hong Kong ( officially the Hong Kong Special Administrative Region, is a territory located on China 's south coast on the Pearl River Delta, and borders P. Rang, M. M. Dale, J. M. Ritter, R. J. Flower, Churchhill Livingston, Elsevier, 6th Edition

References

External links

eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors
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