· Blood flow decreased due to an intrinsic defect in cardiac function -either the heart muscle, or the valves are dysfunctional.
· Heart is unable to pump the blood to body.
· In myocardial infarction, when the amount of damaged ischemic muscle may be so great that the heart cannot pump anymore. The decreased contractility causes a decrease in stroke volume.
Risk Factors for Cardiogenic Shock
· Myocardial infarction
· Valvular damage
· Cardiac tamponade
· Pulmonary edema (non cardiogenic)
↓cardiac contractibility → ↓ in stroke volume and C.O. → pulmonary congestion, ↓ed systemic perfusion , ↓coronary artery perfusion
Dimionished heart souds
Acute ↓ in BP ( > 30mmHg)
Tachypnoea, shallow breath
Perfused sweating, cold and clammy extremities
Weak , thready pulse
Primary goal is to improve myocardial muscle function
Inotropes:Dobutamine increases myocardial contractility in the presence of normal or slightly decreased blood pressure
Intra-aortic balloon pump: reduces the workload of the heart and improves perfusion of the coronary artery.