Cardiogenic Shock Program

Cardiogenic shock is a life-threatening condition in which the heart is in a low cardiac output state, resulting in end-organ hypo-perfusion and hypoxia. Most commonly, cardiogenic shock happens because of a severe heart attack but may also occur due to other illnesses. Regardless of cause, if not treated promptly, the condition can become fatal or cause serious complications.

Causes leading Cardiogenic Shock

• Acute myocardial infarction
• Heart failure
• Infection of the heart valves (endocarditis)
• Inflammation of the heart muscle (myocarditis)
• Pericardial tamponade
• Arrhythmias
• Pulmonary embolism (PE)

Cardiogenic shock is often difficult to diagnose in a timely manner, that is why we have implemented a cardiogenic shock program, which will expedite multidisciplinary discussions to initiate the life-saving protocols that will minimize the variations in care regarding evaluation, management and the use of an appropriate hemodynamic support device, when appropriate.

Most patients presenting with cardiogenic shock are presenting with signs and symptoms of an acute heart attack or with congestive heart failure.

Other clinical criteria for cardiogenic shock

• Systolic blood pressure <90mm Hg for > 30 min
• Lactate >2 mmol/L
• Evidence of end organ hypoperfusion: acute kidney injury/acute liver injury/acute lung injury/altered mental state.

Patients in cardiogenic shock require rapid treatment in order to make sure blood flow to vital organs are restored. Treatments include coronary revascularization, medications, surgery or other procedures such as mechanic support.

Mechanical support devices used at Lovelace Medical center.

Percutaneous Left Ventricular assist devices:

• Impella 2.5
• Impella CP
• Impella 5.5
• Tandem Heart

Veno-arterial and Veno-venous extra-corporeal membrane oxygenation:

• Tandem Life
• Tandem Lung