CARDIOGENIC SHOCK: PATHOPHYSIOLOGY, CLASSIFICATION AND CAUSES

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Cardiac shock is sometimes known as “pump failure” and is a condition of decreased cardiac output that severely impairs cardiac perfusion. It reflects severe left-sided heart failure.

Pathophysiology

  • Inability to contract. When the heart muscle does not contract enough to maintain adequate cardiac output, the stroke volume decreases and the heart cannot eject enough blood with each contraction.

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  • Pulmonary congestion. Blood retracts behind the weakened left ventricle, which increases preload and causes pulmonary congestion.
  • Compensation. In addition, to compensate for the decrease in stroke volume, the heart rate increases in an effort to maintain cardiac output.
  • Decreased stroke volume. As a result of reduced stroke volume, coronary perfusion and collateral blood flow decreased.
  • Increased workload. All of these mechanisms increase the heart’s workload and promote left-sided heart failure.
  • The final result. The result is myocardial hypoxia, a greater decrease in cardiac output, and the induction of compensatory mechanisms to prevent decompensation and death.

rating

The causes of cardiogenic shock are known as either coronary or non-coronary artery.

  • Coronary artery. Coronary cardiogenic shock is more common than non-coronary cardiogenic shock, and it appears most often in patients with acute myocardial infarction.
  • Non-coronary. Non-coronary cardiogenic shock is associated with conditions that stress the heart muscle as well as conditions that lead to ineffective cardiomyopathy.

the reasons

Cardiogenic shock can be caused by any condition that significantly improves left ventricular function with reduced cardiac output.

  • Myocardial infarction (MI)
  • Myocardial ischemia
  • End-stage cardiomyopathy

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