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

• Excess administration of vasodilators and venodilators
• Apical balloon syndrome

References

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