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.