Cardiogenic shock causes: Difference between revisions
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===Common Causes=== | ===Common Causes=== | ||
==Causes by Organ System== | ==Causes by Organ System== | ||
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==Causes in Alphabetical Order== | ==Causes in Alphabetical Order== | ||
==Causes of Cardiogenic Shock Classified According to 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]] | |||
*Chordal rupture, from [[degenerative disease]] or [[trauma]]<ref>{{Cite book | last1 = Hasdai | first1 = David. | title = Cardiogenic shock : diagnosis and treatmen | date = 2002 | publisher = Humana Press | location = Totowa, N.J. | isbn = 1-58829-025-5 | pages = }}</ref> | |||
===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 [[venodilator|venodilators]] | |||
* [[Apical balloon syndrome]] or [[Takotsubo cardiomyopathy]]<ref name="Gianni2006">{{cite journal|last1=Gianni|first1=M.|title=Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review|journal=European Heart Journal|volume=27|issue=13|year=2006|pages=1523–1529|issn=0195-668X|doi=10.1093/eurheartj/ehl032}}</ref> | |||
===Miscellaneous=== | |||
* [[Bezold-Jarisch reflex]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 00:12, 1 May 2014
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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]
Overview
Cardiogenic shock may occur in the setting of different cardiac conditions, therefore assessing its source in the cardiac patient may be challenging. These cardiac conditions may involve different structures of the heart including: myocardial or pericardial disease, valvular disease, acute coronary syndrome or different mechanical injuries to the heart, described below. Nevertheless, considering the predominance of coronary artery disease today, ACS is the most common cause of this type of shock. To reach the right diagnosis, the clinician will have to gather information from the history and clinical examination, however, since most conditions may present with overlapping syndromes, timing and changes in these findings are of outermost importance.[1] Auxiliary tools, such as echocardiography and electrocardiography, are crucial in differentiating and identifying the possible causes of cardiogenic shock.[2][3]
Causes
Life Threatening Causes
Common Causes
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | No underlying causes |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | No underlying causes |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
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
- Tachycardia mediated cardiomyopathy
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
- ↑ Hasdai, David. (2002). Cardiogenic shock : diagnosis and treatmen. Totowa, N.J.: Humana Press. ISBN 1-58829-025-5.
- ↑ Hasdai, David. (2002). Cardiogenic shock : diagnosis and treatmen. Totowa, N.J.: Humana Press. ISBN 1-58829-025-5.
- ↑ 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.
- ↑ 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.