Cardiogenic shock causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Causes

The causes of cardiogenic shock can be classified on the basis of the underlying pathophysiologic mechanism:

Systolic left ventricular dysfunction

• Acute MI

• Congestive heart failure (CHF)

• Cardiomyopathy

• Coronary artery bypass grafting

• Myocarditis

• Myocardial contusion

• Hypophosphatemia as can be seen in the refeeding syndrome)

• Septic shock with myocardial depression

Diastolic left ventricular dysfunction

• Subendocardial ischemia

• Excess wall stress

• Valvular heart disease

• Hypertensive crisis

Obstruction of left ventricular outflow and increased after load

• Aortic stenosis

• Coarctation of the aorta

• Hypertrophic obstructive cardiomyopathy (HOCM)

• Malignant hypertension

Reversal of flow into the left ventricle

• Aortic insufficiency

• Endocarditis

• Aortic dissection

Inadequate left ventricular filling due to mechanical causes

• Tamponade
• Mitral stenosis
• Atrial myxoma

Inadequate left ventricular filling due to inadequate filling time

• Tachycardia

• Tachycardia mediated cardiomyopathy

Conduction abnormalities

• Atrioventricular block

• Sinus bradycardia

Mechanical defect

• Ventricular septal defect (VSD)
• Ruptured chordae
• Myocardial rupture of the left ventricular free wall

Right ventricular failure

• Pulmonary embolism

• Hypoxic pulmonary vasoconstriction

Iatrogenic

• Iatrogenic due to excess administration of vasodilators and venodilators
• Apical balloon syndrome