Medical history (history) represents an important component in the diagnosis of cardiogenic shock* (CS). Family History What is the current health status of your family members? Social anamnesis Current medical history/systemic history (somatic and psychological complaints) [third-party history, if applicable]. What symptoms have you noticed? Are you experiencing rapid pulse, nausea, weakness, shortness of breath, … Cardiogenic Shock: Medical History
Respiratory System (J00-J99) Pulmonary hemorrhage, unspecified Tension pneumothorax – life-threatening condition characterized by collapse of the lung with development of excess pressure. Certain conditions originating in the perinatal period (P00-P96). Liver rupture (liver laceration) as a birth injury. Splenic rupture (rupture of the spleen) as a birth injury. Blood, blood-forming organs – immune system (D50-D90). … Cardiogenic Shock: Or something else? Differential Diagnosis
The following are the major conditions or complications that may be contributed to by cardiogenic shock: Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99). Multi-organ failure (MODS, multi-organ dysfunction syndrome; MOF: multiple organ failure) – simultaneous or sequential failure or severe functional impairment of various vital organ systems of the body. Prognostic … Cardiogenic Shock: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: Assessment of consciousness using the Glasgow Coma Scale (GCS). General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes (central cyanosis? (bluish discoloration of skin and central mucous membranes, e.g., tongue)) [Flush (seizure-like redness). Urticaria … Cardiogenic Shock: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin). Electrolytes – calcium, chloride, potassium, magnesium, sodium, phosphate. Fasting glucose (fasting blood glucose). Blood gas analysis (ABG) – for circulatory instability/shock; determination of: Venous: pH, BE (lactate) [lactate ↑ = oxygen deficiency due to inhibition … Cardiogenic Shock: Test and Diagnosis
Therapeutic target Stabilization of circulatory conditions to counteract the development of multiple organ failure. Therapy recommendations Prompt surgical intervention for Infarct-related cardiogenic shock (ICS) → percutaneous coronary intervention (PCI), usually as stent implantation [coronary revascularization is key predictor of long-term survival] (see topics of the same name below) Shock-inducing pericardial tamponade/effusion, tension pneumothorax. In hypovolemia … Cardiogenic Shock: Drug Therapy
Mandatory medical device diagnostics. Continuous monitoring of vital signs: Blood pressure (RR): blood pressure measurement* /if necessary, invasive blood pressure measurement* [most important symptoms of IkS – but not obligatory – hypotension (low blood pressure) < 90 mmHg systolic for at least 30 minutes, in conjunction with signs of organ diminished perfusion (organ diminished blood … Cardiogenic Shock: Diagnostic Tests
The following symptoms and complaints may indicate cardiogenic shock (CS): Systolic arterial blood pressure, persistent (sustained) at <90 mmHg, or need for catecholamine administration to maintain blood pressure at >90 mmHg. Note: In approximately 25% of patients in cardiogenic shock, blood pressure may also be just above the above limit due to peripheral vasoconstriction (vasoconstriction). … Cardiogenic Shock: Symptoms, Complaints, Signs
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 … Cardiogenic Shock: Causes
General measures Immediately make an emergency call! (Call number 112) Symptom-oriented positioning of the patient: Dyspnea (shortness of breath): elevate upper body (semi-sitting). Circulatory dysregulation (hypovolemia: decrease in circulating blood volume): flat positioning with legs elevated (Trendelenburg positioning). Clouding of consciousness: stable lateral position (to keep the airways free: fall back of the tongue and … Cardiogenic Shock: Therapy
