What is Cardiogenic Shock?
WHAT CAUSES CARDIOGENIC SHOCK?
- Myocardial Infarction, Ischemia (MOST COMMON CAUSE)
- Sustained Cardiac Dysrhythmias
- Acute Valvular Dysfunction
- Blunt Cardiac Trauma
- End-Stage Cardiomyopathy
MYOCARDIAL INFARCTION MANIFESTATIONS
- Cardiac Related Chest Pain
- Pale, Cool, Clammy Skin
- Tachypnea, Crackles, Pulmonary Edema
- Tachycardia, Tachydysrhytmias
- Altered Mental Status
- Hypotension
- Minimal Urine Output
CARDIOGENIC SHOCK ASSESSMENT
- Start by assessing Airway, Breathing, and Circulation (ABC)
- With any form of shock: ALWAYS DETERMINE THE CAUSE OF CARDIOGENIC SHOCK
- Electrocardiogram
- Chest X-Ray
- ABG
- Echocardiogram
- Lab Work: CBC, Platelet Count, Liver Function Tests, Renal Function Tests, Lactate Levels
CARDIOGENIC SHOCK INTERVENTION
- If Cardiogenic Shock is caused by pulmonary edema in the lung interstitium, Airway management with positive end-expiratory pressure (PEEP) mechanical ventilation.
- Decrease preload by decreasing venous return to the heart
Semi-Fowler or Fowler Position- Nitroglycerin
- Diuretics
- Morphine
- Increase cardiac contractility
- Dobutamine (positive inotropes)
- Intra-aortic balloon pump (IABP)
- Decrease afterload by decreasing the resistance the heart must pump against
- Nitroglycerin
- Nitroprusside
- Antihypertensives
- Cardiac Catheterization
- Angioplasty
- Treat dysrhythmias
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