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Cardiogenic shock

  • Alternative Names

    Shock - cardiogenic

    • Chest pain or pressure
    • Profuse sweating, moist skin
    • Rapid breathing
    • Rapid pulse
    • Restlessness, agitation, confusion
    • Shortness of breath
    • Skin that feels cool to the touch
    • Pale skin color or blotchy (mottled) skin
    • Weak (thready) pulse
    • Decreased mental status
      • Loss of ability to concentrate
      • Loss of alertness
    • Coma (loss of consciousness)

    Signs and tests

    An examination will reveal:

    • Low blood pressure (less than 90 systolic)
    • Blood pressure drop of more than 10 points when you stand up after lying down (orthostatic hypotension)
    • Weak (thready) pulse

    To diagnose cardiogenic shock, a catheter (tube) may be placed in the pulmonary artery (right heart catheterization). Measurements often indicate that blood is backing up into the lungs and the heart is not pumping properly.

    Tests include:

    • Cardiac catheterization
    • Chest x-ray
    • Coronary angiography
    • Echocardiogram
    • Electrocardiogram
    • Nuclear scans

    Other studies may be recommended to determine why the heart is not functioning properly.

    Laboratory tests include:

    • Arterial blood gas
    • Blood chemistry ( chem-7, chem-20, electrolytes)
    • Cardiac enzymes (troponin, CKMB)
    • Complete blood count (CBC)