CARDIOGENIC SHOCK: CAUSES, SYMPTOMS, DANGERS, AND TREATMENT

WHAT IS CARDIOGENIC SHOCK

Cardiogenic shock is a rare life-threatening condition in which the heart suddenly becomes unable to pump enough blood to meet the needs of the body and, in particular, noble organs such as the brain and kidneys.

The most common cause is a heart attack.

CAUSES

Technically, cardiogenic shock is the condition in which there is a significant reduction in cardiac output (the volume of blood that the right and left ventricles are able to expel in one minute) following a problem with the heart.

The most common cause is a heart attack ( heart attack ), but other conditions that can cause cardiogenic shock include:

Other heart conditions

• Heart failure
• Arrhythmia
• Direct trauma to the heart

Other health conditions

• Cardiac tamponade (accumulation of fluid in the chest)
• Internal bleeding
• Pulmonary embolism
• Injuries that can put severe pressure on the heart

Medications and medical procedures

• Beta-blockers
• Calcium channel blockers
• Cardiac catheterization.

Risk factors

• Among the most common risk factors able to favor the onset of cardiogenic shock we remember:
• Male sex (however, it should be noted that women also run a greater risk of experiencing symptoms early)
• Advanced age (more than 75 years)
• Cardiocirculatory disorders
• Atherosclerosis  (plaques in the arteries that carry oxygenated blood)
• Cardiomyopathy
• Conduction disorders of the heart
• Heart attack
• Heart failure
• High cholesterol
• High triglycerides
• Hypertension (high blood pressure)
• Myocarditis (inflammation of the heart)
• Heart valve disease
• Ischemic heart disease

Other diseases

• Diabetes and prediabetes
• Overweight and obesity
• Pneumothorax (accumulation of air in the pleural space, the membrane that surrounds the lungs)
• Sepsis
• Cardiac bypass

SYMPTOMS

The signs and symptoms of cardiogenic shock are variables depending on the extent of the drop in blood pressure and how rapidly this occurs; it is, therefore, possible to initially develop only mild ailments that gradually worsen, as well as suddenly lose consciousness.

Lowering blood pressure can in itself cause dizziness, confusion , and nausea, but doctors may also feel a weak or irregular pulse, often accompanied by tachycardia  (increased heart rate ).

The patient may also develop:

• Shortness of breath and hunger for air
• Distention of the veins in the neck (which will then appear more swollen)
• Icy (cold) sweating
• Swelling of the feet
• Decreased urine output
• Loss of consciousness.

COMPLICATIONS

Cardiogenic shock is a medical emergency that requires immediate hospital care because delicate and sensitive organs such as the brain and kidneys no longer receive adequate amounts of oxygenated blood.

They can quickly develop

• Permanent brain damage
• Kidney failure
• Liver damage.

Untreated cardiogenic shock is fatal; in the event of a timely diagnosis, mortality, unfortunately, remains very high, for example following a heart attack equal to 60-65%.

DIAGNOSIS

The diagnosis of shock is clinical, that is, conducted through a medical examination alone, through observation of symptoms, and the measurement of blood pressure (the maximum, systolic, is generally less than 90 mm / Hg).

It is then possible to resort to numerous instrumental and laboratory tests to paint a clearer picture of the situation and the causes that led to the state of shock:

• Blood tests (relating to heart, liver, kidney function, and evaluation of lactate, which is increased)
• Blood gas analysis  to quantify the amount of circulating carbon dioxide
• Cardiac ct scan
• Chest x-ray
• Coronary angiography
• Echocardiography
• Electrocardiogram

TREATMENT

Cardiogenic shock is a life-threatening condition that requires rapid diagnosis and emergency medical treatment to support or restore blood flow thereby preventing organ damage.

In parallel, it is necessary to identify the triggering cause to intervene in its correction.

MEDICINES

• Anti-arrhythmics to restore a regular heartbeat
• Anticoagulants / antiplatelet agents to favor the dissolution of any clots in the case of coronary heart attacks
• Vasopressor and inotropic medicines to support blood pressure
• Surgery and other medical procedures
• Reopening of the coronary arteries or bypass surgery
• Percutaneous interventions ( angioplasty and stent placement )
• Defibrillation
• Cardioversion
• Pacemaker placement

Other

• Fluid therapy (administration of intravenous fluids to ensure the presence of an adequate volume of blood)
• Oxygen therapy
• Dialysis in case of severe renal insufficiency
• Mechanical ventilation in case of respiratory problems

PREVENTION

The prevention of cardiogenic shock is substantially comparable to that of heart attack and cardiovascular diseases in general:

• Avoid exposure to smoke and quit smoking
• Lose weight if necessary
• Improve your diet and in particular
• Reduce the intake of saturated fats (mainly from foods of animal origin, such as meats and dairy products)
• Reduce your consumption of salt
• Increase your consumption of fruits and vegetables
• Reduce the consumption of sugar (and sweet foods in general)
• Reduce alcohol consumption
• Practice regular physical activity