Cardiogenic Shock

Cardiogenic shock (CS; synonyms: cardiac shock; cardiorespiratory collapse; cardiovascular shock; ICD-10-GM R57.0: Cardiogenic shock) is a form of shock caused by pumping failure of the heart. This results in the heart no longer being able to provide the required cardiac output (CV).

Hemodynamically (“fluid mechanics of blood“), shock is defined as sustained systolic blood pressure < 80 mmHg or arterial mean < 60 mmHg.

The most common triggers of cardiogenic shock (CS) in myocardial infarction (MI; heart attack) (= infarct-related cardiogenic shock; IkS) are left heart 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%).

To the extent that myocardial infarction has preceded, the diagnosis of “infarct-related cardiogenic shock” should be made on the basis of clinical symptoms and noninvasive hemodynamic measurements.

The prevalence (disease incidence) of myocardial infarction (MI) with cardiogenic shock (CS) is approximately 10%.

The course and prognosis depend on the severity of cardiogenic shock. 5-10% of all myocardial infarction patients in 1975-2005 suffered cardiogenic shock acutely or within the first few days, as a result of which 50-80% died. Today, for patients with acute ST-segment elevation myocardial infarction (STEMI) admitted to the hospital, the lethality (mortality relative to the total number of people suffering from the disease) is only 10%. However, in myocardial infarction (MI) with cardiogenic shock (CS), which occurs together in approximately 10% of cases, the lethality is still very high at 50%.