Cardiogenic shock: what it is, causes, symptoms and treatment

Cardiogenic shock occurs when the heart loses its ability to pump blood in an adequate amount to the organs, causing a marked decrease in blood pressure, lack of oxygen in the tissues and accumulation of fluid in the lungs.

This type of shock is one of the biggest complications of acute myocardial infarction and if not treated urgently, it can lead to death in almost 50% of cases. Thus, if cardiogenic shock is suspected, it is very important to go to the hospital immediately to confirm the diagnosis and initiate appropriate treatment.

Main signs and symptoms

Symptoms that may indicate possible cardiogenic shock are:

• Rapid breathing; Excessive increase in heart rate; Sudden fainting; Weak pulse; Sweat without apparent cause; Pale skin and cold extremities; Decreased amount of urine.

In cases where there is an accumulation of fluid in the lungs or pulmonary edema, shortness of breath and abnormal sounds may appear when breathing, such as wheezing, for example.

Since cardiogenic shock is more common after a heart attack, these symptoms are also accompanied by heart attack symptoms, such as a feeling of pressure in the chest, tingling in the arm, a feeling of a ball in the throat or nausea. See a more complete list of signs that may indicate a heart attack.

How to confirm the diagnosis

The diagnosis of cardiogenic shock needs to be made as soon as possible in the hospital, so if there is a suspicion it is very important to go quickly to the emergency room. The doctor may use some tests, such as blood pressure measurement, electrocardiogram or chest X-ray, to confirm the cardiogenic shock and start the most appropriate treatment.

Possible causes of cardiogenic shock

Although infarction is the most frequent cause of cardiogenic shock, other problems can also cause this complication. Other possible causes include:

• Heart valve diseases; Right ventricular failure; Acute myocarditis; Coronary artery disease; Cardiac arrhythmias; Direct trauma to the heart; Poisoning of the heart by drugs and toxins;

In addition, in the most advanced stage of sepsis, which is a generalized infection of the organism, cardiogenic shock may also occur, almost always resulting in death. Check how to identify a case of sepsis, to start treatment and avoid cardiogenic shock.

How the treatment is done

Treatment for cardiogenic shock is usually started right at the hospital's emergency room, but then it is necessary to stay in an intensive care unit, where various types of treatment can be done to try to relieve symptoms, improve heart function and facilitate circulation blood:

1. Use of medicines

In addition to the serum that is applied directly to the vein to maintain hydration and nutrition, the doctor can also use:

• Remedies to increase the strength of the heart, such as Noradrenaline or Dopamine; Aspirin, to reduce the risk of clot formation and facilitate blood circulation; Diuretics, such as Furosemide or Spironolactone, to decrease the amount of fluid in the lung.

These remedies are also administered directly into the vein, at least during the first week of treatment, and can then be taken orally, when the condition improves.

2. Catheterization

This type of treatment is done to restore circulation to the heart, in the event of a heart attack, for example. For this, the doctor usually inserts a catheter, which is a long, long thin, through an artery, usually in the neck or groin area, to the heart to remove a possible clot and allow the blood to pass properly again.

Understand more about how catheterization is done and what it is for.

3. Surgery

Surgery is usually only used in the most severe cases or when symptoms do not improve with the use of medication or catheterization. In these cases, the surgery can serve to correct an injury to the heart or to do a cardiac bypass, in which the doctor places another artery in the heart so that the blood passes to the region that is without oxygen due to the presence of a clot.

When the functioning of the heart is very affected and no technique works, the last stage of treatment is to have a heart transplant, however, it is necessary to find a compatible donor, which can be quite complicated. Learn more about heart transplantation.

Main complications

Complications of cardiogenic shock are the failure of multiple noble organs such as kidneys, brain and liver, being responsible for most deaths of patients admitted to intensive care. These complications can be avoided whenever the diagnosis and treatment are made early.