Treatments and drugs

By Mayo Clinic Staff

Cardiogenic shock treatment focuses on repairing the damage to your heart muscle and other organs caused by lack of oxygen.

Emergency life support

During this treatment, which most people who have cardiogenic shock need, you're given extra oxygen to breathe, to minimize damage to your muscles and organs. If necessary, you'll be connected to a breathing machine (ventilator). You'll receive medications and fluid through an intravenous (IV) line in your arm.

Medications

Medications to treat cardiogenic shock work to improve blood flow through your heart and increase your heart's pumping ability.

  • Aspirin. Emergency medical workers may give you aspirin soon after they arrive on the scene or as soon as you get to the hospital. Aspirin reduces blood clotting and helps keep your blood flowing through a narrowed artery. Take an aspirin yourself while waiting for help to arrive only if your doctor has previously told you to do so for symptoms of a heart attack.
  • Thrombolytics. These drugs, also called clot busters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and lessen the damage to your heart. You'll usually receive thrombolytics only if emergency cardiac catheterization isn't available.
  • Superaspirins. Doctors in the emergency room may give you drugs similar to aspirin to help prevent new clots from forming. These include medications, such as oral clopidogrel (Plavix) and medications called platelet glycoprotein IIb/IIIa receptor blockers, which are given through a vein (intravenously).
  • Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less likely to form clots. IV or injectable heparin usually is given during the first few days after a heart attack.
  • Inotropic agents. You may be given medications, to improve and support your heart function until other treatments start to work.

Medical procedures

Medical procedures to treat cardiogenic shock usually focus on restoring blood flow through your heart. They include:

  • Angioplasty and stenting. If a blockage is found during a cardiac catheterization, your doctor can insert a long, thin tube (catheter) equipped with a special balloon through an artery, usually in your leg, to a blocked artery in your heart. Once in position, the balloon is briefly inflated to open the blockage. A metal mesh stent may be inserted into the artery to keep it open over time. In most cases, you doctor will place a stent coated with a slow-releasing medication to help keep your artery open.
  • Balloon pump. Your doctor inserts a balloon pump in the main artery off of your heart (aorta). The pump inflates and deflates within the aorta, helping blood flow and taking some of the workload off your heart.

Surgery

If medications and medical procedures don't work to treat cardiogenic shock, your doctor may recommend surgery.

  • Coronary artery bypass surgery. This involves sewing veins or arteries in place at a site beyond a blocked coronary artery. Your doctor may suggest this procedure after your heart has had time to recover from your heart attack. Occasionally, bypass surgery is performed on an emergency basis.
  • Surgery to repair an injury to your heart. Sometimes an injury, such as a tear in one of your heart's chambers or a damaged heart valve, can cause cardiogenic shock. Your doctor may recommend surgery to correct the problem.
  • Heart pumps. These mechanical devices, called ventricular assist devices, are implanted into the abdomen and attached to the heart to help it pump. Implanted heart pumps can extend and improve the lives of some people with end-stage heart failure who aren't able to undergo heart transplantation or are waiting for a new heart.
  • Heart transplant. If your heart is so damaged that no other treatments work, a heart transplant may be a last resort.
Oct. 09, 2014

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