Line 170:
Line 170: *[[Diuretics]]
*[[Diuretics]]
*[[Endocarditis]]
*[[Endocarditis]]
*[[Excess ventricular wall stress]]
*Excess [[ventricular]] wall stress
*[[Free wall rupture]]
*[[Free wall rupture]]
*[[Hemorrhagic pericardial effusion]]
*Hemorrhagic [[pericardial effusion]]
*[[Hypertensive crisis]]
*[[Hypertensive crisis]]
*[[Hypertrophic cardiomyopathy]]
*[[Hypertrophic cardiomyopathy]]
Line 179:
Line 179: *[[Iatrogenic]]
*[[Iatrogenic]]
*[[Inferior myocardial infarction]]
*[[Inferior myocardial infarction]]
*[[Inferoposterior infarction]]
*[[Posterior myocardial infarction| Inferoposterior infarction]]
*[[Interventricular septum rupture]]
*[[Rupture of the ventricular septum| Interventricular septum rupture]]
*[[Left ventricle failure]]
*[[Left ventricle failure]]
*[[Left ventricular free wall rupture]]
*[[Left ventricular free wall rupture]]
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] echocardiography and electrocardiography , are crucial in differentiating and identifying the possible causes of cardiogenic shock.[ 2] [ 3]
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 Causes by Organ System
Cardiovascular
No underlying causes
Chemical/Poisoning
Acute aortic perforation , Acute aortic syndrome , Acute coronary syndrome , Acute myocardial infarction , Acute pulmonary embolism , Acute stent thrombosis , Acute valvular regurgitation , Anterior myocardial dysfuntion , Aortic dissection , Aortic insufficiency , Aortic regurgitation , Aortic stenosis , Apical ballooning cardiomyopathy , Arrhythmias , Atrial fibrillation , Atrial flutter , Atrial myxoma , Atrioventricular block , Bezold-jarisch reflex , Cardiac tamponade , Chordal rupture , Coarctation of the aorta , Compression of the heart , Congenital lesions , Congestive heart failure , Constrictive pericarditis , Coronary artery bypass grafting , Coronary artery disease , Dilated cardiomyopathy , Endocarditis , Excess ventricular wall stress , Free wall rupture , Hemorrhagic pericardial effusion , Hypertensive crisis , Hypertrophic cardiomyopathy , Hypophosphatemia , Hypoxic pulmonary vasoconstriction , Inferior myocardial infarction , Inferoposterior infarction , Interventricular septum rupture , Left ventricle failure , Left ventricular free wall rupture , Mechanical obstruction , Mitral regurgitation , Mitral stenosis , Multivessel coronary artery disease , Myocardial disease , Myocardial infarction , Myocarditis , Myopericarditis , Non-st elevation myocardial infarction (nstemi) , Papillary muscle dysfunction , Papillary muscle rupture , Pericardial disease , Pericardial effusion , Pericardial tamponade , Pneumothorax , Prior valvular disease , Pulmonary embolism , Retrograde dissection of ascending aorta , Right ventricle infarction , Right ventricular failure , Rupture of chordae tendineae , Ruptured ventricular free wall aneurysm , Septic shock with myocardial depression , Severe cardiomyopathy , Severe pulmonary hypertension , Sinus bradycardia , St elevation myocardial infarction (stemi) , Stress-induced cardiomyopathy , Subendocardial ischemia , Tako-tsubo cardiomyopathy , Tension pneumothorax , Three vessel coronary disease , Unsuspected coronary dissection , Unsuspected coronary perforation , Valvular defect , Valvular disease , Vasodilators , Venodilators , Ventricular fibrillation , Ventricular septal defect , Ventricular septal rupture , Ventricular tachycardia
Dental
No underlying causes
Dermatologic
No underlying causes
Drug Side Effect
Anaphylaxis , Angiotensin converting enzyme inhibitors , Beta-blockers , Calcium channel blockers , Diuretics , Morphine , Nitrates , Vasodilators , Venodilators
Ear Nose Throat
No underlying causes
Endocrine
No underlying causes
Environmental
No underlying causes
Gastroenterologic
No underlying causes
Genetic
Congenital lesions , Valvular defect , Ventricular septal defect
Hematologic
Hypophosphatemia
Iatrogenic
Acute aortic perforation , Acute stent thrombosis , Anaphylaxis , Angiotensin converting enzyme inhibitors , Beta-blockers , Calcium channel blockers , Coronary artery bypass grafting , Diuretics , Iatrogenic , Morphine , Nitrates , Unsuspected coronary dissection , Unsuspected coronary perforation , Vasodilators , Venodilators
Infectious Disease
No underlying causes
Musculoskeletal/Orthopedic
No underlying causes
Neurologic
Apical ballooning cardiomyopathy , Bezold-jarisch reflex , Sinus bradycardia , Stress-induced cardiomyopathy , Tako-tsubo cardiomyopathy
Nutritional/Metabolic
No underlying causes
Obstetric/Gynecologic
No underlying causes
Oncologic
Atrial myxoma
Ophthalmologic
No underlying causes
Overdose/Toxicity
No underlying causes
Psychiatric
No underlying causes
Pulmonary
Acute pulmonary embolism , Hypoxic pulmonary vasoconstriction , Pneumothorax , Pulmonary embolism , Severe pulmonary hypertension , Tension pneumothorax
Renal/Electrolyte
No underlying causes
Rheumatology/Immunology/Allergy
Anaphylaxis , Constrictive pericarditis , Endocarditis , Myocarditis , Myopericarditis , Septic shock with myocardial depression
Sexual
No underlying causes
Trauma
Acute aortic perforation , Aortic dissection , Chordal rupture , Compression of the heart , Papillary muscle rupture , Pericardial tamponade , Retrograde dissection of ascending aorta , Rupture of chordae tendineae , Trauma , Ventricular septal rupture
Urologic
No underlying causes
Miscellaneous
Acute aortic syndrome , Acute coronary syndrome , Acute myocardial infarction , Acute pulmonary embolism , Acute valvular regurgitation , Anterior myocardial dysfuntion , Aortic dissection , Aortic insufficiency , Aortic regurgitation , Aortic stenosis , Apical ballooning cardiomyopathy , Arrhythmias , Atrial fibrillation , Cardiac tamponade , Chordal rupture , Coarctation of the aorta , Compression of the heart , Congestive heart failure , Coronary artery disease , Dilated cardiomyopathy , Endocarditis , Excess ventricular wall stress , Free wall rupture , Hemorrhagic pericardial effusion , Hypertensive crisis , Hypertrophic cardiomyopathy , Hypophosphatemia , Hypoxic pulmonary vasoconstriction , Inferior myocardial infarction , Inferoposterior infarction , Interventricular septum rupture , Left ventricle failure , Left ventricular free wall rupture , Mechanical obstruction , Mitral regurgitation , Mitral stenosis , Multivessel coronary artery disease , Myocardial disease , Myocardial infarction , Myocarditis , Myopericarditis , Non-st elevation myocardial infarction (nstemi) , Papillary muscle dysfunction , Papillary muscle rupture , Pericardial disease , Pericardial effusion , Pericardial tamponade , Pneumothorax , Prior valvular disease , Pulmonary embolism , Retrograde dissection of ascending aorta , Right ventricle infarction , Right ventricular failure , Rupture of chordae tendineae , Ruptured ventricular free wall aneurysm , Septic shock with myocardial depression , Severe cardiomyopathy , Severe pulmonary hypertension , Sinus bradycardia , St elevation myocardial infarction (stemi) , Stress-induced cardiomyopathy , Subendocardial ischemia , Tako-tsubo cardiomyopathy , Tension pneumothorax , Three vessel coronary disease , Valvular defect , Valvular disease , Ventricular fibrillation , Ventricular septal defect , Ventricular septal rupture , Ventricular tachycardia
Causes in Alphabetical Order Causes of Cardiogenic Shock Classified According to Underlying Pathophysiologic Mechanism Systolic Left Ventricular Dysfunction Diastolic Left Ventricular Dysfunction Obstruction of Left Ventricular Outflow and Increased After Load Reversal of Flow into the Left Ventricle Inadequate Left Ventricular Filling due to Mechanical Causes Inadequate Left Ventricular Filling due to Inadequate Filling Time Conduction Abnormalities Mechanical Defect Right Ventricular Failure Iatrogenic 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 .
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