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Cardiogenic shock is a medical emergency resulting from inadequate blood flow to the body's organs due to the dysfunction of the heart. Signs of inadequate blood flow include low urine production (<30 mL/hour), cool arms and legs, and decreased level of consciousness.
Shock from blood loss occurs in about 1–2% of trauma cases. [34] Overall, up to one-third of people admitted to the intensive care unit (ICU) are in circulatory shock. [42] Of these, cardiogenic shock accounts for approximately 20%, hypovolemic about 20%, and septic shock about 60% of cases. [43]
A complication that may occur in the acute setting soon after a myocardial infarction or in the weeks following is cardiogenic shock. Cardiogenic shock is defined as a hemodynamic state in which the heart cannot produce enough of a cardiac output to supply an adequate amount of oxygenated blood to the tissues of the body. [14]
Cardiogenic shock as a result of the heart being unable to adequately pump blood may develop, dependent on infarct size, and is most likely to occur within the days following an acute myocardial infarction. Cardiogenic shock is the largest cause of in-hospital mortality.
This is sometimes “sub” classified as obstructive shock, but you can see that the cause is still due to the heart’s inability to do its job, right? Similarly to hypovolemic shock, a reduction in cardiac output leads to lowered blood flow, so the skin gets cool and clammy and so cardiogenic shock is also considered a kind of cold shock.
Onset may be rapid (acute) or more gradual (subacute). [10] [2] Signs of cardiac tamponade typically include those of cardiogenic shock including shortness of breath, weakness, lightheadedness, cough [1] and those of Beck's triad e.g. jugular vein distention, quiet heart sounds and hypotension.
The physiology of obstructive shock is similar to cardiogenic shock. In both types, the heart's output of blood (cardiac output) is decreased. This causes a back-up of blood into the veins entering the right atrium. [3] Jugular venous distension can be observed in the neck. This finding can be seen in obstructive and cardiogenic shock.
With continued signs of shock and no signs of fluid overload, kids can continue to receive 10-20 ml/kg of fluids with a max of 60 ml/kg in the first hour. However, if cardiogenic shock is suspected, kids should receive less fluids over a longer time (e.g., 5-10 ml/kg over 15-30 min). [6]