CCRN Notes

Cardiogenic Shock

A condition where the heart fails as a pump, leading to inadequate tissue perfusion.

Most common cause of Cardiogenic Shock

Large myocardial infarction (MI) with greater than 40% left ventricular (LV) involvement.

Causes of Cardiogenic Shock

Includes cardiomyopathy, valvular dysfunction, arrhythmias, and mechanical complications such as papillary muscle rupture.

Hemodynamic Profile of Cardiogenic Shock

Decreased cardiac output (CO) or cardiac index (CI), elevated pulmonary artery occlusion pressure (PAOP), and elevated systemic vascular resistance (SVR).

Indicators of Cardiogenic Shock Hypotension

Systolic blood pressure (SBP) less than 90 mmHg or mean arterial pressure (MAP) less than 65 mmHg.

Clinical signs of Cardiogenic Shock

Cold, clammy skin; altered mental status; oliguria; elevated lactate; pulmonary congestion.

Management strategies for Cardiogenic Shock

Optimize oxygenation, use inotropes like dobutamine, vasopressors like norepinephrine, and avoid excessive fluids.

Definition of Shock

Inadequate tissue perfusion leading to cellular hypoxia.

Main categories of Shock

Distributive, Cardiogenic, Hypovolemic, Obstructive.

Distributive Shock characteristics

Widespread vasodilation and loss of vascular tone with low systemic vascular resistance (SVR).

Common cause of Distributive Shock

Septic shock, which is caused by infection.

Hypovolemic Shock cause

Inadequate circulating volume from hemorrhage or fluid loss.

Key feature of Obstructive Shock

Mechanical obstruction to blood flow impairing cardiac output.

Differentiation of Shock types by Hemodynamics

Distributive: ↓SVR, ↑CO; Cardiogenic: ↑SVR, ↓CO; Hypovolemic: ↑SVR, ↓CO; Obstructive: Variable SVR, ↓CO.

Lactate elevation in Shock

Indicates tissue hypoperfusion regardless of the type of shock.