The Cardiogenic Shock
Monday, November 23rd, 2009It is defined as a state of hypo-perfusion tissue associated with dysfunction of the heart pump. Its main cause is myocardial infarction in acute phase.
Cardiogenic shock from myocardial infarction is associated:
- the extent of necrosis of the left ventricular mass mainly
- a mechanical complications: cardiogenic shock secondary
- septal rupture responsible for CIV
- acute mitral regurgitation due to rupture or dysfunction pillar of mitral
- much more rarely, rupture of the free wall of left ventricle in charge of tamponade.
- the extension of an infarction less than the right ventricle
Symptoms:
In addition to signs of acute infarction, there are signs of tissue hypoperfusion:
- neurological signs: agitation, confusion, stupor,
- Signs peripheral coldness, pallor, mottling, cyanosis,
- Renal signs: oligo-anuria,
- hemodynamic signs: systolic blood pressure <90 mm Hg, toe pressure differential pressure, tachycardia with pulse spinning,
- signs of elevated filling pressures left (pulmonary edema, gallop …) and right (jugular turgor, hepato-jugular reflux).