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Encyclopedia > Cardiogenic shock
Cardiogenic shock
Classifications and external resources
ICD-10 R57.0
ICD-9 785.51

Cardiogenic shock is based upon an inadequate circulation of blood due to primary failure of the ventricles of the heart to function effectively.[1] [2] [3] [4] [5] The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ... In the heart, a ventricle is a heart chamber which collects blood from an atrium (another heart chamber that is smaller than ventricle) and pumps it out of the heart. ... The heart and lungs, from an older edition of Greys Anatomy. ...


Since this is a category of shock there is insufficient perfusion of tissue (i.e. the heart) to meet the required demand for oxygen and nutrients. This leads to cell death from oxygen starvation, hypoxia. Because of this it may lead to cardiac arrest (or circulatory arrest) which is an acute cessation of cardiac pump function.[4] Shock is a serious medical condition where the tissue perfusion is insufficient to meet the required supply of oxygen and nutrients. ... Perfusion is a physiological term that refers to the process of nutritive delivery of arterial blood to a capillary bed in the biological tissue. ... Look up Tissue on Wiktionary, the free dictionary The word tissue has several meanings: Aerial tissu is an acrobatic art form, and is one of the circus arts. ... The heart and lungs, from an older edition of Greys Anatomy. ... General Name, Symbol, Number oxygen, O, 8 Chemical series Nonmetals, chalcogens Group, Period, Block 16, 2, p Appearance colorless (gas) very pale blue (liquid) Atomic mass 15. ... Nutrients and the body A nutrient is any element or compound necessary for or contributing to an organisms metabolism, growth, or other functioning. ... Cells in culture, stained for keratin (red) and DNA (green). ... General Name, Symbol, Number oxygen, O, 8 Chemical series Nonmetals, chalcogens Group, Period, Block 16, 2, p Appearance colorless (gas) very pale blue (liquid) Atomic mass 15. ... Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia) or region of the body (tissue hypoxia) is deprived of adequate oxygen supply. ...

Contents


Etiology

Cardiogenic shock is caused by the failure of the heart to pump effectively. It can be due to damage to the heart muscle, most often from a large myocardial infarction. Other causes include arrhythmia, cardiomyopathy, cardiac valve problems, ventricular outflow obstruction (i.e. aortic valve stenosis, aortic dissection, systolic anterior motion (SAM) in hypertrophic cardiomyopathy) or ventriculoseptal defects. [1] [2] [4] [3] [5] [6] [7] The heart and lungs, from an older edition of Greys Anatomy. ... A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, totally occluding the artery and preventing blood flow downstream. ... Cardiac arrhythmia is a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal. ... Grays Fig. ... Aortic valve stenosis (AS) is a heart condition caused by the incomplete opening of the aortic valve. ... Aortic dissection is a tear in the wall of the aorta (the largest artery of the body). ... Hypertrophic cardiomyopathy, or HCM, is a disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is hypertrophied (thickened) without any obvious cause. ...


Signs and symptoms

  • Anxiety, restlessness, altered mental state due to decreased cerebral perfusion and subsequent hypoxia.
  • Hypotension due to decrease in cardiac output.
  • A rapid, weak, thready pulse due to decreased circulation combined with tachcardia.
  • Cool, clammy, and mottled skin (cutis marmorata), due to vasoconstriction and subsequent hypoperfusion of the skin.
  • Distended jugular veins due to increased jugular venous pressure.
  • Oliguria (low urine output) due insufficient renal perfusion if condition persists.
  • Rapid and deep respirations (hyperventilation) due to sympathetic nervous system stimulation and acidosis.
  • Fatigue due to hyperventilation and hypoxia.
  • Absent pulse in tachyarrhythmia.

The Glasgow Coma Scale is a neurological scale used to assess level of consciousness after head trauma and, importantly, to help keep track of patients progress over a period of time. ... Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia) or region of the body (tissue hypoxia) is deprived of adequate oxygen supply. ... Cardiac output is the volume of blood being pumped by the heart in a minute. ... Jugular vein - Wikipedia, the free encyclopedia /**/ @import /skins-1. ... A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. ...

Diagnosis

Electrocardiogram

An Electrocardiogram helps establishing the exact diagnosis and guides treatment, it may reveal: ECG may also refer to the East Coast Greenway Lead II An Electrocardiogram (ECG or EKG, abbreviated from the German Elektrokardiogramm) is a graphic produced by an electrocardiograph, which records the electrical voltage in the heart in the form of a continuous strip graph. ...

Cardiac arrhythmia is a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal. ...

Radiology

Echocardiography may show arrhythmia, signs of PED, ventricular septal rupture (VSR), an obstructed outflow tract or cardiomyopathy. It has been suggested that Transesophageal_echocardiogram be merged into this article or section. ...


Swan-ganz catheter

The Swan-ganz catheter or Pulmonary artery catheter may assist in the diagnosis by providing informaton on the hemodynamics. In medicine pulmonary artery catheterization is the insertion of a catheter into a pulmonary artery. ...


Biopsy

In case of suspected cardiomyopathy a biopsy of heart muscle may be needed to make a definite diagnosis. A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Diagnosis (from the Greek words dia = by and gnosis = knowledge) is the process of identifying a disease by its signs, symptoms and results of various diagnostic procedures. ...


Treatment

In cardiogenic shock: depending on the type of myocardal infarction one can infuse fluids or in shock refractory to infusing fluids inotropica. In case of cardiac arrhythmia several anti-arrhytmic agents may be administered, i.e. adenosine, verapamil, amiodarone, β-blocker. Positive inotropic agents, which enhance the heart's pumping capabilities, are used to improve the contractility and correct the hypotension. Should that not suffice an intra-aortic balloon pump (which reduces workload for the heart, and improves perfusion of the coronary arteries) can be considered or a left ventricular assist device (which augments the pump-function of the heart). [1] [2] [3] An inotrope is an agent which increases or decreases the force or energy of muscular contractions. ... Cardiac arrhythmia is a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal. ... The chemical structure of adenosine Adenosine is a nucleoside comprised of adenine attached to a ribose (ribofuranose) moiety via a β-N9-glycosidic bond. ... Verapamil (brand names: Isoptin®, Verelan®, Calan®) is a medical drug that acts as an L-type calcium channel blocker. ... Amiodarone belongs to a class of drugs called Vaughan-Williams Class III antiarrhythmic agent. ... Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... An inotrope is an agent which increases or decreases the force or energy of muscular contractions. ... The Intra-aortic balloon pump (IABP) is a mechanical device that is used to increase myocardial oxygen supply and decrease myocardial oxygen demand as well as increase cardiac output. ... In cardiac physiology, afterload is the tension produced by a chamber of the heart in order to contract. ... The coronary circulation consists of the blood vessels that supply blood to, and remove blood from, the heart. ... A Ventricular assist device, or VAD, is mechanical device that is used to partially or completely replace the function of a failing heart. ...


See also

The Intra-aortic balloon pump (IABP) is a mechanical device that is used to increase myocardial oxygen supply and decrease myocardial oxygen demand as well as increase cardiac output. ... A Ventricular assist device, or VAD, is mechanical device that is used to partially or completely replace the function of a failing heart. ...

Notes

  1. ^ a b c Irwin and Rippe's Intensive Care Medicine by Irwin and Rippe, Fifth Edition (2003), Lippincott Williams & Wilkins, ISBN 0-7817-3548-3
  2. ^ a b c The ICU Book by Paul Marino MD, PhD, Second Edition (1997), Lippincott Williams & Wilkins, ISBN 0-683-05565-8
  3. ^ a b c Fundamental Critical Care Support, A standardized curriculum of Critical Care by the Society of Critical Care Medicine
  4. ^ a b c Textbooks of Internal Medicine
    • Harrison's Principles of Internal Medicine 16th Edtion, The McGraw-Hill Companies, ISBN 0-07-140235-7
    • Cecil Textbook of Medicine by Lee Goldman, Dennis Ausiello, 22nd Edtion (2003), W.B. Saunders Company, ISBN 0-7216-9652-X
    • The Oxford Textbook of Medicine Edited by David A. Warrell, Timothy M. Cox and John D. Firth with Edward J. Benz, Fourth Edition (2003), Oxford University Press, ISBN 0-19-262922-0
  5. ^ a b Shock: An Overview PDF by Michael L. Cheatham, MD, Ernest F.J. Block, MD, Howard G. Smith, MD, John T. Promes, MD, Surgical Critical Care Service, Department of Surgical Education, Orlando Regional Medical Center Orlando, Florida
  6. ^ Cardiogenic shock Department of Anaesthesia and Intensive Care of The Chinese University of Hong Kong
  7. ^ Introduction to management of shock for junior ICU trainees and medical students Department of Anaesthesia and Intensive Care of The Chinese University of Hong Kong

Lippincott Williams & Wilkins is an academic medical publisher, founded in 1792 and now part of the Wolters Kluwer group. ... Lippincott Williams & Wilkins is an academic medical publisher, founded in 1792 and now part of the Wolters Kluwer group. ... The McGraw-Hill Companies logo. ... Oxford University Press (OUP) is a highly-respected publishing house and a department of the University of Oxford in England. ... PDF is an abbreviation with several meanings: Portable Document Format Post-doctoral fellowship Probability density function There also is an electronic design automation company named PDF Solutions. ... Nickname: The City Beautiful, O-Town Location in Orange County and the state of Florida. ...

References

  • Irwin, R.S., Rippe, J.M., Curley, F.J., Heard, S.O. (1997) Procedures and Techniques in Intensive Care Medicine (3rd edition). Boston: Lippincott, Williams and Wilkins.
  • Marino, P. (1997) The ICU Book. (2nd edition). Philadelphia: Lippincott, Williams and Wilkins.

External links


  Results from FactBites:
 
Cardiogenic Shock - Health Centers (582 words)
Cardiogenic shock is a disease state where the heart is damaged enough that it is unable to supply sufficient blood to the body.
Cardiogenic shock can be caused by disorders of the heart muscle, the valves, or the heart's electrical conduction system.
To diagnose cardiogenic shock, a catheter (tube) may be placed in the pulmonary artery.
  More results at FactBites »

 
 

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