Cardiogenic Shock (Last Updated - 3/3/2005)

-myocardial pump failure leading to peripheral ischemia
-carries a mortality rate of ~85% (2)
-due to either:

     1) Intrinsic myocardial damage
          -Ex.) myocardial infarction (MI) --> with >40% of LV affected

     2) Extrinsic Pressure
          -Ex.) cardiac tamponade from a ruptured ventricular aneurysm

     3) Outflow obstruction
          -Ex.) pulmonary embolus (PE) or severe aortic stenosis (AS)

     4) Serious ventricular arrythmias
          -Ex.) ventricular fibrillation (VFib)

-Physiologic Findings:
     1) Decreased cardiac output (CO)
     2) Increased pulmonary capillary wedge pressure (PCWP) --> left atrial pressure (LAP)
          -predisposes pts. to acute pulmonary edema with PCWP's > 24 mmHg
     3) Increased right atrial pressure (RAP)
     4) Increased peripheral vascular resistance (PVR)
     5) Decreased venous oxygen saturation

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References:

1) Robbins Pathologic Basis of Disease - 6th Edition - 1999. Pg. 134.
2) Guyton's Textbook of Medical Physiology - 10th Edition - 2000. Pgs. 230-231.