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Cardiogenic shock is a major, and frequently fatal, complication of a variety of acute and chronic disorders that impair the ability of the heart to maintain adequate tissue perfusion. Cardiogenic shock is characterized by a decreased pumping ability of the heart that causes a shocklike state. Cardiogenic shock is the commonest cause of death after acute myocardial infarction. It occurs in 7% of patients with ST segment elevation myocardial infarction and 3% with non-ST segment elevation myocardial infarction. It most commonly occurs in association with, and as a direct result of, acute myocardial infarction. Decreased coronary perfusion pressure and increased myocardial oxygen demand play a role in the vicious cycle that leads to cardiogenic shock. Cardiogenic Shock is the most serious consequence of myocardial infarction, but can also result from other cardiac emergencies, such as cardiac tamponade. A sudden and severe drop in the blood pressure and blood flow through the body because the heart is not pumping normally. Cardiogenic shock is based upon an inadequate circulation of blood due to primary failure of the ventricles of the heart to function effectively. Patients who develop cardiogenic shock from acute MI consistently have evidence of progressive myocardial necrosis with infarct extension. Cardiogenic shock has a death rate of about 60% and is the major cause of death in patients hospitalized for a heart attack. Getting immediate medical treatment for a heart attack is important in preventing the development of cardiogenic shock.

Causes of Cardiogenic shock

The main causes of Cardiogenic shock:

• Myocardial Infarction (heart attack).
• Diastolic - Ventricular hypertrophy and restrictive cardiomyopathies.
• Losing about 1/5 or more of the normal amount of blood in your body causes hypovolemic shock.
• Severe valvular heart disease, particularly aortic stenosis.
• Acute, severe pulmonary embolism.
• Myocardial suppression due to bacteraemia/sepsis (although, strictly speaking, this would be defined as septic shock).

Signs and symptoms of Cardiogenic shock

Signs and symptoms often experienced with Cardiogenic shock are:

• Profuse sweating.
• Low blood pressure.
• Chest pain.
• Nausea and vomiting.
• Rapid breathing.
• Dyspnoea.
• Loss of ability to concentrate.
• Fatigue due to hyperventilation and hypoxia.

Treatment of Cardiogenic shock

Some most common treatmet of Cardiogenic Shock:

• Intra-aortic balloon counterpulsation (IABP) to improve heart and blood vessel ( cardiovascular ) function.
• Intravenous fluids, including blood and blood products, may be given if indicated.
• Medicines such as dopamine , dobutamine, epinephrine, and norepinephrine may be needed to increase blood pressure and the amount of blood pumped out of the heart.
• Careful monitoring in an intensive care unit is necessary. Further treatment depends on the cause. Fluids and medications given intravenously (through a vein directly into the bloodstream) are used to maintain blood flow.