Cardiogenic shock causes: Difference between revisions
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The most common causes of cardiogenic shock remain:<ref name="ReynoldsHochman2008">{{cite journal|last1=Reynolds|first1=H. R.|last2=Hochman|first2=J. S.|title=Cardiogenic Shock: Current Concepts and Improving Outcomes|journal=Circulation|volume=117|issue=5|year=2008|pages=686–697|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.106.613596}}</ref> | The most common causes of cardiogenic shock remain:<ref name="ReynoldsHochman2008">{{cite journal|last1=Reynolds|first1=H. R.|last2=Hochman|first2=J. S.|title=Cardiogenic Shock: Current Concepts and Improving Outcomes|journal=Circulation|volume=117|issue=5|year=2008|pages=686–697|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.106.613596}}</ref> | ||
*[[Myocardial infarction]]<ref name="pmid29300230">{{cite journal |vauthors=Acharya D |title=Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock |journal=Cardiol Rev |volume=26 |issue=5 |pages=255–266 |date=2018 |pmid=29300230 |pmc=6082598 |doi=10.1097/CRD.0000000000000190 |url=}}</ref> | *[[Myocardial infarction]]<ref name="pmid29300230">{{cite journal |vauthors=Acharya D |title=Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock |journal=Cardiol Rev |volume=26 |issue=5 |pages=255–266 |date=2018 |pmid=29300230 |pmc=6082598 |doi=10.1097/CRD.0000000000000190 |url=}}</ref> | ||
*[[Left ventricular failure]] | *[[Left ventricular failure]]<ref name="pmid24930078">{{cite journal |vauthors=Sánchez Marteles M, Urrutia A |title=[Acute heart failure: acute cardiogenic pulmonary edema and cardiogenic shock] |language=Spanish; Castilian |journal=Med Clin (Barc) |volume=142 Suppl 1 |issue= |pages=14–9 |date=March 2014 |pmid=24930078 |doi=10.1016/S0025-7753(14)70077-6 |url=}}</ref> | ||
However, other likewise important causes must be identified. These may be classified according to their nature into: | However, other likewise important causes must be identified. These may be classified according to their nature into: | ||
:* ''Arrhythmic'' | :* ''Arrhythmic'' | ||
Revision as of 22:02, 29 December 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2] Syed Musadiq Ali M.B.B.S.[3]
Overview
The most common cause of cardiogenic shock is acute myocardial infarction with left ventricular dysfunction. Less commonly, right ventricular myocardial infarction can lead to cardiogenic shock. Other causes of cardiogenic shock include mechanical injuries such as acute valvular regurgitation or rupture, free wall rupture, and ventricular septum rupture.
Causes
Life Threatening Causes
Cardiogenic Shock is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated.
Common Causes
The most common causes of cardiogenic shock remain:[1]
However, other likewise important causes must be identified. These may be classified according to their nature into:
- Arrhythmic
- Mechanical
- Acute mitral regurgitation (papillary muscle rupture, chordae tendinae rupture)
- Free wall rupture
- Hypertrophic cardiomyopathy
- Obstruction to left ventricular filling (mitral stenosis, left atrial myxoma)
- Obstruction to left ventricular outflow tract (aortic stenosis, hypertrophic obstructive cardiomyopathy)
- Ventricular septal defect
- Myopathic
- Pharmacologic
Causes by Organ System
Causes in Alphabetical Order
Causes of Cardiogenic Shock Classified According to Underlying Pathophysiologic Mechanism
Systolic Left Ventricular Dysfunction
- Hypophosphatemia as can be seen in the refeeding syndrome)
- Septic shock with myocardial depression
Diastolic Left Ventricular Dysfunction
- Subendocardial ischemia
- Excess wall stress
Obstruction of Left Ventricular Outflow and Increased After Load
Reversal of Flow into the Left Ventricle
- Aortic insufficiency
- Endocarditis
- Aortic dissection
- Chordal rupture, from degenerative disease or trauma[4]
Inadequate Left Ventricular Filling due to Mechanical Causes
Inadequate Left Ventricular Filling due to Inadequate Filling Time
Conduction Abnormalities
Mechanical Defect
- Ventricular septal defect (VSD)
- Ruptured chordae
- Myocardial rupture of the left ventricular free wall
Right Ventricular Failure
Iatrogenic
- Excess administration of vasodilators and venodilators
- Apical balloon syndrome or Takotsubo cardiomyopathy[5]
Miscellaneous
References
- ↑ Reynolds, H. R.; Hochman, J. S. (2008). "Cardiogenic Shock: Current Concepts and Improving Outcomes". Circulation. 117 (5): 686–697. doi:10.1161/CIRCULATIONAHA.106.613596. ISSN 0009-7322.
- ↑ Acharya D (2018). "Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock". Cardiol Rev. 26 (5): 255–266. doi:10.1097/CRD.0000000000000190. PMC 6082598. PMID 29300230.
- ↑ Sánchez Marteles M, Urrutia A (March 2014). "[Acute heart failure: acute cardiogenic pulmonary edema and cardiogenic shock]". Med Clin (Barc) (in Spanish; Castilian). 142 Suppl 1: 14–9. doi:10.1016/S0025-7753(14)70077-6. PMID 24930078.
- ↑ Hasdai, David. (2002). Cardiogenic shock : diagnosis and treatmen. Totowa, N.J.: Humana Press. ISBN 1-58829-025-5.
- ↑ Gianni, M. (2006). "Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review". European Heart Journal. 27 (13): 1523–1529. doi:10.1093/eurheartj/ehl032. ISSN 0195-668X.