Cardiogenic shock: a life-threatening condition
Cardiogenic shock is a condition in which the heart suddenly stops pumping enough blood to meet the oxygen and nutrition needs of our body.
Cardiogenic shock is usually caused by a severe heart attack, but not every patient with a heart attack develops cardiogenic shock.
Cardiogenic shock contributes to maximum fatalities in patients with acute myocardial infection (MI). Though the consoling fact is, that with immediate attention more than half of the people who develop this condition usually survive.
How cardiogenic shock develops?
A severe heart attack hampers the pumping capacity of the heart. It deprives the body of the optimal amount of oxygen-rich blood, causing cardiogenic shock.
In addition to a heart attack, some other conditions may decrease the pumping capacity of the heart and can make a person vulnerable to cardiogenic shock. These are:
- Myocarditis or inflammation of heart muscles
- Arrhythmias or irregular heartbeat/rhythm
- Pulmonary embolism or blockage of an artery in the lung
- Endocarditis or infection in the inner lining or valves of the heart
- Pericardial tamponade or excessive fluid or blood around the heart
What are the common signs and symptoms of cardiogenic shock?
- Severe shortness of breath
- Weak pulse
- Sudden and rapid heartbeat
- Cold hands or feet
- Decrease or complete stoppage of urination
- Rapid breathing
- Pale skin
- Loss of consciousness
- Low blood pressure
- Sweating
Since cardiogenic shock results from a severe heart attack, we should be aware of the symptoms of heart attack as well
- Squeezing pain in the center of the chest or feeling of pressure or fullness, lasting for more than a few minutes
- Pain radiating to shoulder, arms (single or both), back, or teeth, and jaw
- Recurring episodes of chest pain
- Light-headedness or sudden dizziness
- Sweating
- Nausea and vomiting
How do clinicians diagnose a cardiogenic shock?
Several tests are performed to confirm if a person has a cardiogenic shock or not.
- Blood Pressure Examination- It causes extremely low BP
- Cardiac catheterization – A thin and long tube (catheter) is inserted into an artery to check the amount of blood the heart is pumping with each beat.
- Electrocardiogram (ECG)- Examination of heart’s electrical activity
- Echocardiogram or ultrasound of the heart
- Chest X-ray for checking fluid in lungs and looking for any abnormalities in heart
- Blood tests- To assess the damage (if any) to major organs like kidneys and liver due to decreased oxygen supply
Who is more prone to cardiogenic shock?
A patient with a heart attack has more chances of developing cardiogenic shock if he/she is
- Old
- Has a history of heart attack or heart failure
- Has blockages in major arteries
- Has a history of diabetes or blood pressure
- Smoker
How can I prevent myself from getting cardiogenic shock?
The best way to prevent yourself from getting cardiogenic shock is by avoiding risk factors for heart attack. The golden mantra is keeping your heart healthy and blood pressure in control.
Some habits which can help us in making our heart strong are:
- Avoid smoking (active as well as passive)
- Keep your body weight in check. Obesity often comes up with other risk factors for a heart attack like diabetes and hypertension.
- Limit intake of saturated fats and trans fats
- Limit your sodium intake to less than 2,300 milligrams (mg) a day.
- Avoid hidden sources of Sodium like canned and processed food
- Limit your sugar intake
- Limit your alcohol consumption to one or two drinks on the days when you are drinking
- Exercise regularly – A 150 minutes of moderate exercise or 75 minutes of vigorous activity a week, or a combination of both can make you and your heart healthy.
What to do if someone has symptoms of heart attack or cardiogenic shock?
Getting the treatment of heart attack quickly may improve the chances of survival and reduces the impact of cardiogenic shock. The less time a person is in shock, the better is the outcome with minimum damage to major organs. If you or someone you know have symptoms of a heart attack, immediately reach out to emergency medical services for help.
Dr. Dhananjay R S | Consultant – Cardiology – Adult, Cardiology – Paediatric | SS Narayana Heart Centre, Davangere