14. Cardiogenic shock: Causes and hemodynamics
In cardiogenic shock the systolic BP is lower than 90 mmHg and the urine production is low.
Causes
- Acute myocardial infarction
- When more than 40% of myocardium is affected
- Obstructive hypertrophic cardiomyopathy
- Pericardial tamponade
- End-stage of heart failure
- Arrhythmias
Pathomechanism
End-diastolic volume and end-diastolic pressure will increase as the heart can’t pump out blood. The central venous pressure will also increase.
| EDV and EDp | ↑ |
| Central venous pressure | ↑ |
| Stroke volume | ↓ |
| Cardiac Output | ↓ |
| Blood pressure | ↓ |
| Heart rate | ↑ |
| Total peripheral resistance | ↑ or normal |
| Blood volume | Normal |
| Blood distribution | Not normal |
| Circulatory velocity | ↓ |