Cardiogenic shock happens when your heart suddenly can't pump enough blood to your body. Whether it results from a severe heart attack or not, cardiogenic shock can be deadly if it's not treated immediately.
According to Dr. James Park, medical director of Heart & Vascular Services at Texas Health Dallas, the heart fails in cardiogenic shock. He says blood presure is so low it can't support profusion to your end organs like your brain or liver.
"A lot of them are caused by heart attacks, a bad one," Dr. Park said. "There can be other situations like if somebody had cardiomyopathy, where the heart's big and baggy, and isn't working well. That's more of a chronic condition. It just gets worse."
Texas Health Dallas is one of 60 hospitals nationwide — and the only one in Texas — taking part in a study to increase survival rates for cardiogenic shock.
Dr. Park is the lead researcher at Texas Health Dallas on the project.
What causes cardiogenic shock: "The fact that the heart isn’t able to do its job usually means that the muscle is damaged or the muscle can’t move like it should."
Signs of cardiogenic shock: "It’s a clue that the clinician — the cardiologist or the E-R staff — has to be in tune with because sometimes it can be missed."
- The patient can appear to be cool to the touch — their extremities, in particular.
- The other big clue is their systolic blood pressure — the top number — is generally 80 or 90 or lower. So if someone is hanging 65, 70 systolic blood pressure, something's bad.
- The key is to detect that early. There's a very high mortality rate in the realm of 70 percent.
Other cardiogenic shock signs and symptoms include:
- Rapid breathing
- Severe shortness of breath
- Sudden, rapid heartbeat (tachycardia)
- Loss of consciousness
- Weak pulse
- Pale skin
- Urinating less than normal or not at all
Dr. Park says two new protocols have raised the survival rate from 50 to 72 percent:
- "First, a mechanical device called left ventricle support is put through the groin (like angioplasty), and a device called the impella assists the heart. It sucks the blood from the left ventricle and gets it past the aortic valve to the aorta where the blood gets into end organs like your brain, kidneys and liver. It’s actually doing the work of the heart."
- "Second, once you put the device in, you fix the patient’s arteries and they're doing well, there’s an algorithm to show you the power the heart’s putting out. Using that and using catheters inside the pulmonary artery from the right side of the heart, we’re able to detect if the patient’s getting better."