Cardiogenic Shock

Excerpt

Cardiogenic shock is defined as a primary cardiac disorder that results in both clinical and biochemical evidence of tissue hypoperfusion. Clinical criteria include a systolic blood pressure of less than or equal to 90 mm Hg for greater than or equal to 30 minutes or support to maintain systolic blood pressure less than or equal to 90 mm Hg and urine output less than or equal to 30 mL/hr or cool extremities. Hemodynamic criteria include a depressed cardiac index (less than or equal to 2.2 liters per minute per square meter of body surface area) and an elevated pulmonary-capillary wedge pressure greater than 15 mm Hg.

Cardiogenic shock is a clinical entity characterized by a low cardiac output state of circulatory failure that results in end-organ hypoperfusion and tissue hypoxia. The most common cause of cardiogenic shock is acute myocardial infarction, though other disorders leading to impairment of the myocardium, valves, conduction system, or pericardium also can result in cardiogenic shock. Despite advances in reperfusion therapy and mechanical circulatory support treatments, morbidity, and mortality among patients with cardiogenic shock remain high.