Pathogenesis (development of disease)
Cardiogenic shock (CS) occurs because of acute pumping failure of the heart.
The most common triggers of cardiogenic shock (CS) in myocardial infarction (MI; myocardial infarction) are left ventricular failure (insufficient pumping capacity of the left heart) (78.5%), mitral regurgitation (inability of the mitral valve to close between the left atrium and the left ventricle/heart chamber) (6.9%), Ventricular septal rupture (serious complication of acute myocardial infarction) (3.9%), right heart failure (inadequate pumping of the right heart) (2.8%), cardiac tamponade (accumulation of fluid in the pericardium) (1.4%), and other (6.7%).
In cardiogenic shock, there is pathophysiological death of cardiac cells, excessive inflammatory reactions and loss of barrier function of blood vessels (vascular integrity) (= “lethal triad”).
For the pathogenesis of cardiogenic shock (CS) in myocardial infarction (MI), see the above triggers and their pathogenesis (disease development) below.
Etiology (Causes)
Disease-related causes
- Acute left heart failure (LHV).
- Acute right heart failure (RHV)
- Aneurysm dissecans – cleavage of the arterial wall.
- Embolism/thrombosis of the vena cava – occlusion of the vena cava by an embolus/thrombus.
- Decompensated cardiac ventricles (valvular defects).
- Cardiac arrhythmias such as ventricular tachycardia (ventricular tachycardia).
- Cardiomyopathy – group of heart muscle diseases that leads to a reduction in cardiac function.
- Pulmonary embolism – occlusion of a pulmonary vessel.
- Mitral regurgitation – inability of the mitral valve to close between the left atrium and the left ventricle/heart chamber.
- Myocardial infarction (heart attack) – about 90% of patients survive a myocardial infarction; if cardiogenic shock occurs initially or in the course of a myocardial infarction, then the survival rate of infarct-related cardiogenic shock (ICS) patients is only about 50%, due to the formation of a multiorgandysfunction syndrome (MODS)/simultaneous or sequential failure or severe functional impairment of various vital organ systems of the body
- Myocarditis (inflammation of the heart muscle).
- Papillary muscle rupture – acute life-threatening condition that leads to limitation of heart valve function.
- Pericardial tamponade – tamponade of the pericardium resulting in cardiac compression.
- Rupture (tear) of an aortic aneurysm – bulge in the vessel wall.
- Traumatic rupture of a heart valve
- Ventricular septal rupture – serious complication of acute myocardial infarction.
