Cardiogenic shock causes

Cardiogenic Shock Microchapters
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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.

Causes

The causes of cardiogenic shock can be classified on the basis of the underlying pathophysiologic mechanism:

Systolic Left Ventricular Dysfunction

• Acute MI

• Congestive heart failure (CHF)

• Cardiomyopathy

• Coronary artery bypass grafting

• Myocarditis

• Myocardial contusion

• Hypophosphatemia as can be seen in the refeeding syndrome)

• Septic shock with myocardial depression

Diastolic Left Ventricular Dysfunction

• Subendocardial ischemia

• Excess wall stress

• Valvular heart disease

• Hypertensive crisis

Obstruction of Left Ventricular Outflow and Increased After Load

• Aortic stenosis

• Coarctation of the aorta

• Hypertrophic obstructive cardiomyopathy (HOCM)

• Malignant hypertension

Reversal of Flow into the Left Ventricle

• Aortic insufficiency

• Endocarditis

• Aortic dissection

Inadequate Left Ventricular Filling due to Mechanical Causes

• Tamponade
• Mitral stenosis
• Atrial myxoma

Inadequate Left Ventricular Filling due to Inadequate Filling Time

• Tachycardia

• Tachycardia mediated cardiomyopathy

Conduction Abnormalities

• Atrioventricular block

• Sinus bradycardia

Mechanical Defect

• Ventricular septal defect (VSD)
• Ruptured chordae
• Myocardial rupture of the left ventricular free wall

Right Ventricular Failure

• Pulmonary embolism

• Hypoxic pulmonary vasoconstriction

Iatrogenic

• Excess administration of vasodilators and venodilators
• Apical balloon syndrome

Miscellaneous

• Bezold-Jarisch reflex

References

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