cardiogenic shock2

8/11/2019 CARDIOGENIC SHOCK2

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CARDIOGENIC SHOCK

By: Rhodeva Braga



• Sometimes called PUMP FAILURE

• A condition wherein there is diminishedcardiac output that severely impairs tissue

perfusion.

• Occurs when the heart’s ability to contract

and pump blood is impaired and the supply

of oxygen is inadequate for the heart andtissues.



2 causes of cardiogenic shock

CORONARY NON-CORONARY



PATHOPHYSIOLOGY



• dysrhythmia

•

Severe hypoxemia

• Cardiac tamponade

• Hypocalcemia

• Cardiomyopathy

• Drug toxicity

• Myocardial infarction



Cardiac output is compromised

BP falls, tissue perfusion is reduced

Impaired tissue perfusion

Weakened heart

Impaired ability to pump



Ventricle does not fully eject its volume

of blood

Fluid accumulates in the lungs

Patients in cardiogenic shock may experience the pain of angina,

develop dysrhythmias, complain of fatigue, express feelings ofdoom, and show signs of hemodynamic instability.



Signs and symptoms:

• Rapid breathing

• Severe shortness of

breath

• Sudden, rapid heartbeat

(tachycardia)

•

Confusion

• Loss of consciousness or

fainting

• Weak pulse

• Sweating

• Pale skin

• Cold hands or feet

• Urinating less than

normal or not at all



DIAGNOSIS



• Auscultation

• Pulmonary artery pressure monitoring (PAP)

•

Arterial Blood Gases

• Electrocardiogram

•

Enzyme levels• Coronary catheterization



MEDICAL MANAGEMENT



GOAL

• To limit further myocardial damage

• To Preserve the healthy myocardium

• To improve the cardiac function

• Increase oxygen supply to the heart muscle



INITIATION OF FIRST LINETREATMENT



• OXYGENATION- nasal cannula at 2-6 L/min

-monitor ABG values and PULSEOXIMETRY values

• PAIN CONTROL- IV morphine

• HEMODYNAMIC MONITORING

• LABORATORY MARKER MONITORING- BNP, CK-

MB, ECG monitoring



PHARMACOLOGIC TREATMENT



DOBUTAMINE

• Enhances the strength of cardiac

contraction, improving stroke

volume ejection and overallcardiac output.



NITROGLYCERINE

• Acts as a vasodilator (low dose)

• Causes arterial vasodilation at higher

dose

• In combination with dobutamine, it

increases cardiac output whileminimizing cardiac workload



DOPAMINE

• May be used with dobutamine and

nitroglycerin to improve tissue perfusion.



OTHER MEDICATIONS:

• Diuretics

• Antiarrhythmic medications

• Mechanical assistive devices



NURSING MANAGEMENT



• Prevent cardiogenic shock

• Monitor hemodynamic status

• Administer medications and iv fluids

• Enhancing safety and comfort



STATISTICS



CARDIOVASCULAR DISEASES

• An estimated 17.3 million people died fromCVDs in 2008, representing 30% of all global

deaths. Of these deaths, an estimated 7.3

million were due to coronary heart diseaseand 6.2 million were due to stroke .

• Low- and middle-income countries are

disproportionally affected: over 80% of CVDdeaths take place in low- and middle-income

countries and occur almost equally in men

and women .



- WHO

• The number of people who die from CVDs,

mainly from heart disease and stroke, will

increase to reach 23.3. million by 2030. CVDsare projected to remain the single leading

cause of death.

• Most cardiovascular diseases can beprevented by addressing risk factors such as

tobacco use, unhealthy diet and obesity,

physical inactivity, high blood pressure,diabetes and raised lipids.



NEWS AND TRENDS

• The theme for World Health Day in 2013

is high blood pressure, also known as

raised blood pressure or hypertension. It

increases the risk of heart attacks,

strokes and kidney failure and if left

uncontrolled, high blood pressure canalso cause blindness, irregular heartbeat

and heart failure.



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LISTENING!!!

cardiogenic shock2

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