Nursing In Ghana

CARDIOGENIC SHOCK (PART 1)

Cardiogenic shock also sometimes known as “pump failure” is a condition of diminished cardiac output that severely impairs cardiac perfusion. It reflects severe left-sided heart failure.

Pathophysiology

  • Inability to contract. When the myocardium can’t contract sufficiently to maintain adequate cardiac output, stroke volume decreases and the heart can’t eject an adequate volume of blood with each contraction.
  • Pulmonary congestion. The blood backs up behind the weakened left ventricle, increasing preload and causing pulmonary congestion.
  • Compensation. In addition, to compensate for the drop in stroke volume, the heart rate increases in an attempt to maintain cardiac output.
  • Diminished stroke volume. As a result of the diminished stroke volume, coronary artery perfusion and collateral blood flow is decreased.
  • Increased workload. All of these mechanisms increase the heart’s workload and enhance left-sided heart failure.
  • End result. The result is myocardial hypoxia, further decreased cardiac output, and a triggering of compensatory mechanisms to prevent decompensation and death.

Classification

The causes of cardiogenic shock are known as either coronary or non-coronary.

  • Coronary. Coronary cardiogenic shock is more common than noncoronary cardiogenic shock and is seen most often in patients with acute myocardial infarction.
  • Noncoronary. Noncoronary cardiogenic shock is related to conditions that stress the myocardium as well as conditions that result in an ineffective myocardial function.
READ ALSO:  POSITIVE SYMPTOMS OF SCHIZOPHRENIA

Causes

Cardiogenic shock can result from any condition that causes significant left ventricular dysfunction with reduced cardiac output.

  • Myocardial infarction (MI)
  • Myocardial ischemia
  • End-stage cardiomyopathy

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Credit: Nurseslabs

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