Causes of Cardiogenic Shock

In this article, we will discuss various Causes of Cardiogenic Shock. So, let’s get started.


1. Following myocardial infarction

(a) Involvement of critical muscle mass (>40%) and/or refractory arrhythmias (80%)

(b) Mechanical complications of AMI (acute myocardial infarction)

  • Acute mitral regurgitation due to rupture of papillary muscle or chordae tendineae of 6-7%
  • Acquired Acquired ventricular septal defect (3-4%)
  • Left ventricular free wall rupture/tamponade
  • Ventricular aneurysm

2. Severe valvular lesions

  • Severe aortic (stenosis/regurgitation) or mitral (stenosis/regurgitation) valve disease
  • Left ventricular outflow tract obstruction
  • Obstructive cardiomyopathy

3. Extracardiac obstructive causes

  • Pericardial effusion with tamponade (1-1.5%)
  • Massive pulmonary embolism
  • Severe pulmonary hypertension (primary or Eisenmenger)
  • Severe restrictive cardiomyopathy

4. Inflammatory/infectious myocardial disease

  • Severe myocarditis
  • Acute endocarditis with myopathic or valvular involvement

5. Severe myocardial depression

  • Septic shock
  • Acidosis or alkalosis
  • Hypoxia
  • Drugs, e.g. beta-blockers, calcium channel blockers, anaesthetics and anti-arrhythmics
  • Post-cardiac arrest, post-cardiotomy

6. End stage of myocardial disease

  • Dilated cardiomyopathy

7. Traumatic, e.g. pericardial, myocardial or valvular injuries.

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