Descripción general

Cardiogenic shock is a condition in which your heart suddenly can't pump enough blood to meet your body's needs. The condition is most often caused by a severe heart attack, but not everyone who has a heart attack has cardiogenic shock.

Cardiogenic shock is rare, but it's often fatal if not treated immediately. If treated immediately, about half the people who develop the condition survive.

Síntomas

Cardiogenic shock signs and symptoms include:

  • Rapid breathing
  • Severe shortness of breath
  • Sudden, rapid heartbeat (tachycardia)
  • Loss of consciousness
  • Weak pulse
  • Low blood pressure (hypotension)
  • Sweating
  • Pale skin
  • Cold hands or feet
  • Urinating less than normal or not at all

Symptoms of a heart attack

Because cardiogenic shock usually occurs in people who are having a severe heart attack, it's important to know the signs and symptoms of a heart attack. These include:

  • Pressure, fullness or a squeezing pain in the center of your chest that lasts for more than a few minutes
  • Pain extending to your shoulder, one or both arms, back, or even to your teeth and jaw
  • Increasing episodes of chest pain
  • Shortness of breath
  • Sweating
  • Lightheadedness or sudden dizziness
  • Nausea and vomiting

Seek medical attention quickly when having these signs or symptoms to decrease your risk of developing cardiogenic shock.

When to see a doctor

Getting heart attack treatment quickly improves your chance of survival and minimizes damage to your heart. If you're having symptoms of a heart attack, call 911 or other emergency medical services for help. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Don't drive yourself.

Causas

In most cases, a lack of oxygen to your heart, usually from a heart attack, damages its main pumping chamber (left ventricle). Without oxygen-rich blood circulating to that area of your heart, the heart muscle can weaken and go into cardiogenic shock.

Rarely, damage to your heart's right ventricle, which sends blood to your lungs to receive oxygen, leads to cardiogenic shock.

Other possible causes of cardiogenic shock include:

  • Inflammation of the heart muscle (myocarditis)
  • Infection of the heart valves (endocarditis)
  • Weakened heart from any cause
  • Drug overdoses or poisoning with substances that can affect your heart's pumping ability

Factores de riesgo

If you have a heart attack, your risk of developing cardiogenic shock increases if you:

  • Are older
  • Have a history of heart failure or heart attack
  • Have blockages (coronary artery disease) in several of your heart's main arteries
  • Have diabetes or high blood pressure
  • Are female

Complicaciones

If not treated immediately, cardiogenic shock can be fatal. Another serious complication is damage to your liver, kidneys or other organs from lack of oxygen, which can be permanent.

Prevención

The best way to prevent cardiogenic shock is to make lifestyle changes to keep your heart healthy and your blood pressure in check.

  • Don't smoke and avoid secondhand smoke. Several years after quitting smoking, your risk of stroke is the same as that of a nonsmoker.
  • Maintain a healthy weight. Being overweight contributes to other risk factors for heart attack and cardiogenic shock, such as high blood pressure, cardiovascular disease and diabetes. Losing just 10 pounds (4.5 kilograms) can lower blood pressure and improve cholesterol levels.
  • Eat less cholesterol and saturated fat. Limiting these, especially saturated fat, can reduce your risk of heart disease. Avoid trans fat.
  • Limit added sugar and alcohol. This will help you avoid nutrient-poor calories and help you maintain a healthy weight.
  • Exercise regularly. Exercise can lower your blood pressure, increase your level of high-density lipoprotein (HDL) cholesterol, and improve the overall health of your blood vessels and heart. Gradually work up to 30 minutes of activity — such as walking, jogging, swimming or bicycling — on most, if not all, days of the week.

If you have a heart attack, quick action can help prevent cardiogenic shock. Seek emergency medical help if you think you're having a heart attack.

Oct. 28, 2017
References
  1. Cardiogenic shock. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/shock. Accessed Aug. 11, 2017.
  2. Hochman JS, et al. Clinical manifestations and diagnosis of cardiogenic shock in acute myocardial infarction. https://www.uptodate.com/contents/search. Accessed Aug. 11, 2017.
  3. Warning signs of heart attack, stroke and cardiac arrest. American Heart Association. http://www.heart.org/HEARTORG/Conditions/911-Warnings-Signs-of-a-Heart-Attack_UCM_305346_SubHomePage.jsp. Accessed Aug. 16, 2017.
  4. The American Heart Associaton's diet and lifestyle recommendations. American Heart Association. http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp#.WZRP5YqQwmI. Accessed Aug. 16, 2017.
  5. Hochman JS, et al. Prognosis and treatment of cardiogenic shock complicating acute myocardial infarction. https://www.uptodate.com/contents/search. Accessed Aug. 11, 2017.
  6. Goldman L, et al., eds. Cardiogenic Shock. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed Sept. 1, 2017.
  7. Napp LC, et al. ECMO in cardiac arrest and cardiogenic shock. Herz. 2017;42:27.
  8. Szymanski FM, et al. Cardiogenic shock — Diagnostic and therapeutic options in the light of new scientific data. Anaesthesiology Intensive Therapy. 2014;46:301.
  9. Lopez-Jimenez F (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 24, 2017.