Editing Cardiogenic shock (section)

{{Short description|Shock due to heart dysfunction}}
{{Infobox medical condition (new)
| name            = Cardiogenic shock
| image           = File:UOTW 7 - Ultrasound of the Week 1.webm
| caption         = Ultrasound image after cardiogenic shock due to [[myocarditis]]<ref name=UOTW7>{{cite web|title=UOTW #7 – Ultrasound of the Week|url=https://www.ultrasoundoftheweek.com/uotw-7/|website=Ultrasound of the Week|access-date=27 May 2017|date=30 June 2014}}</ref>
| pronounce       =
| field           = [[Cardiology]]
| synonyms        =
| symptoms        = [[Fatigue]], [[tachycardia|rapid heartbeat]],
[[dyspnea|shortness of breath]], [[hypotension]], [[sweating]], [[chest pain]], [[dizziness]] or [[Presyncope|lightheadedness]], [[nausea]],  [[decreased level of consciousness]]<ref name=Mayo2020>{{cite web |title=Cardiogenic shock – Symptoms and causes |url=https://www.mayoclinic.org/diseases-conditions/cardiogenic-shock/symptoms-causes/syc-20366739 |website=Mayo Clinic |access-date=22 May 2020 |language=en}}</ref>
| complications   = Worsening of or causing [[heart failure]] and/or [[heart block]], serious [[arrhythmias]] such as [[ventricular fibrillation]], [[cor pulmonale]], respiratory or kidney or liver dysfunction or failure, [[multiple organ dysfunction syndrome]], [[cardiac arrest]], death
| onset           =
| duration        =
| types           =
| causes          = [[Heart attack]], myocarditis, [[endocarditis]], certain medications and substances<ref name=Mayo2020/>
| risks           = [[Heart failure]], old age, [[hypertension]]<ref name=Mayo2020/>
| diagnosis       =
| differential    =
| prevention      =
| treatment       =
| medication      =
| prognosis       = For patients where the cause is not due to a heart attack, the mortality rate is still relatively high, at about 60%; some progress has been made in treating cardiogenic shock when due to a heart attack, and the mortality rate is now somewhat lower for those with MI who survive and are treated rapidly with current therapies (February 2021)<ref>{{cite journal | vauthors = Schrage B, Becher PM, Goßling A, Savarese G, Dabboura S, Yan I, Beer B, Söffker G, Seiffert M, Kluge S, Kirchhof P, Blankenberg S, Westermann D | display-authors = 6 | title = Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock | journal = ESC Heart Failure | volume = 8 | issue = 2 | pages = 1295–1303 | date = April 2021 | pmid = 33605565 | pmc = 8006704 | doi = 10.1002/ehf2.13202 }}</ref>
| frequency       =
| deaths          =
}}

<!-- Definition and symptoms -->
'''Cardiogenic shock''' is a medical emergency resulting from inadequate blood flow to the body's organs due to the dysfunction of the [[heart]]. Signs of inadequate blood flow include low urine production (<30 mL/hour), cool arms and legs, and decreased level of consciousness. People may also have a severely low blood pressure and heart rate.<!-- Cause and diagnosis -->

Causes of cardiogenic shock include [[Cardiomyopathy|cardiomyopathic]], arrhythmic, and mechanical. Cardiogenic shock is most commonly precipitated by [[Acute myocardial infarction|a heart attack]].<ref name=":1" >{{cite journal | vauthors = Vahdatpour C, Collins D, Goldberg S | title = Cardiogenic Shock | journal = Journal of the American Heart Association | volume = 8 | issue = 8 | pages = e011991 | date = April 2019 | pmid = 30947630 | pmc = 6507212 | doi = 10.1161/JAHA.119.011991 }}</ref>

<!-- Treatment -->
Treatment of cardiogenic shock depends on the cause with the initial goals to improve blood flow to the body. If cardiogenic shock is due to a heart attack, attempts to [[Revascularization|open the heart's arteries]] may help. Certain medications, such as dobutamine and milrinone, improve the heart's ability to contract and can also be used. When these measures fail, more advanced options such as mechanical support devices or heart transplantation can be pursued.

<!-- Epidemiology and history -->
Cardiogenic shock is a condition that is difficult to fully reverse even with an early diagnosis.<ref name=":1" /> However, early initiation of treatment may improve outcomes. Care should also be directed to any other organs that are affected by this lack of blood flow (e.g., [[Kidney dialysis|dialysis]] for the kidneys, mechanical ventilation for lung dysfunction).

Mortality rates for cardiogenic shock are high but have been decreasing in the United States. This is likely due to its rapid identification and treatment in recent decades. Some studies have suggested that this is possibly related to new treatment advances. Nonetheless, the mortality rates remain high and multi-organ failure in addition to cardiogenic shock is associated with higher rates of mortality.<ref>{{cite journal | vauthors = Thiele H, de Waha-Thiele S, Freund A, Zeymer U, Desch S, Fitzgerald S | title = Management of cardiogenic shock | journal = EuroIntervention | volume = 17 | issue = 6 | pages = 451–465 | date = August 2021 | pmid = 34413010 | pmc = 9724885 | doi = 10.4244/EIJ-D-20-01296 }}</ref>