What is the treatment for Cardiogenic Shock?

By  ,  National Institute of Health
Jan 06, 2013

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Cardiogenic shock is life threatening and requires emergency medical treatment. In most cases, cardiogenic shock is diagnosed after a person has been admitted to a hospital for a heart attack. If the person isn't already in a hospital, emergency treatment can start as soon as medical personnel arrive.

The goals of emergency treatment for cardiogenic shock are first to treat the shock and then to treat its underlying cause(s).

Sometimes both the shock and its cause are treated at the same time. For example, doctors may quickly open a blocked blood vessel that's causing damage to the heart. Often, this can get the patient out of shock with little or no additional treatment.

Emergency Life Support

Emergency life support treatment is required for any type of shock. This treatment helps get oxygen-rich blood flowing to the brain, kidneys, and other organs.

Restoring blood flow to the organs is necessary to keep the patient alive and to try to prevent long-term damage to the organs. Emergency life support treatment includes:

  •     Giving the patient extra oxygen to breathe so that more oxygen reaches the lungs, the heart, and the rest of the body.
  •     Giving the patient fluids, including blood and blood products, through a needle inserted in a vein (when the shock is due to blood loss). This can help get more blood to major organs and the rest of the body. This treatment usually isn’t done for cardiogenic shock because the heart can't pump the blood that's already in the body. Also, too much fluid is in the lungs, making it hard to breathe.



During and after emergency life support treatment, doctors try to find out what’s causing the shock. If the reason for the shock is that the heart isn't pumping strongly enough, then the diagnosis is cardiogenic shock.

Treatment for cardiogenic shock will depend on its cause. Doctors may prescribe medicines to increase the force with which the heart muscle contracts or to treat a heart attack that may have caused the shock.


Medical Devices and Procedures

In addition to medicines, medical devices can help the heart pump and improve blood flow. The devices most commonly used to treat cardiogenic shock include:

    * Intra-aortic balloon pump - This device is placed in the aorta, the main blood vessel that carries blood from the heart to the body. A large balloon at the tip of the device is inflated and deflated in a rhythm that exactly matches the rhythm of the heart's pumping action. This helps the weakened heart muscle pump as much blood as it can, which helps get more blood to vital organs, such as the brain and kidneys.

    * Angioplasty (AN-jee-oh-plas-tee) and stents - Angioplasty is a procedure used to open narrowed or blocked coronary (heart) arteries and to treat an ongoing heart attack. A stent is a small mesh tube that's placed in a coronary artery during angioplasty to help keep it open.


Sometimes medicines and medical devices aren't enough to treat cardiogenic shock.

Surgery can restore blood flow to the heart and the rest of the body, repair heart damage, and help keep a patient alive while he or she recovers from shock.

Surgery also can improve the chances for long-term survival. Surgery done within 6 hours of the onset of shock symptoms has the greatest chance of improving survival.


The types of surgery used to treat underlying causes of cardiogenic shock include:

  •     Coronary artery bypass grafting - In this surgery, arteries or veins from other parts of the body are used to bypass (that is, go around) narrowed coronary arteries.
  •     Surgery to repair damaged heart valves.
  •     Surgery to repair a break in the wall that separates the heart’s chambers. This break is called a septal rupture.
  •     Surgery to implant a device to help the heart pump blood to the body. This device is called a left ventricular assist device (LVAD) or mechanical circulatory assist. This surgery may be done if damage to the left ventricle is causing shock. The implanted device is a battery-operated pump that takes over part of the heart’s pumping action.
  •     Heart transplant - This is rarely done during an emergency situation like cardiogenic shock because of the other available devices and surgery options. Also, doctors need to do very careful testing to make sure a patient will benefit from a heart transplant and to find a matching heart from a donor. Still, in some cases, doctors may recommend a transplant if they feel it's the best way to improve a patient's chances of long-term survival.


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