CARDIOGENIC SHOCK2
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CARDIOGENIC SHOCK
By: Rhodeva Braga
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• 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.
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2 causes of cardiogenic shock
CORONARY NON-CORONARY
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PATHOPHYSIOLOGY
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• dysrhythmia
•
Severe hypoxemia
• Cardiac tamponade
• Hypocalcemia
• Cardiomyopathy
• Drug toxicity
• Myocardial infarction
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Cardiac output is compromised
BP falls, tissue perfusion is reduced
Impaired tissue perfusion
Weakened heart
Impaired ability to pump
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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.
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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
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DIAGNOSIS
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• Auscultation
• Pulmonary artery pressure monitoring (PAP)
•
Arterial Blood Gases
• Electrocardiogram
•
Enzyme levels• Coronary catheterization
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MEDICAL MANAGEMENT
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GOAL
• To limit further myocardial damage
• To Preserve the healthy myocardium
• To improve the cardiac function
• Increase oxygen supply to the heart muscle
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INITIATION OF FIRST LINETREATMENT
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• 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
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PHARMACOLOGIC TREATMENT
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DOBUTAMINE
• Enhances the strength of cardiac
contraction, improving stroke
volume ejection and overallcardiac output.
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NITROGLYCERINE
• Acts as a vasodilator (low dose)
• Causes arterial vasodilation at higher
dose
• In combination with dobutamine, it
increases cardiac output whileminimizing cardiac workload
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DOPAMINE
• May be used with dobutamine and
nitroglycerin to improve tissue perfusion.
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OTHER MEDICATIONS:
• Diuretics
• Antiarrhythmic medications
• Mechanical assistive devices
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NURSING MANAGEMENT
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• Prevent cardiogenic shock
• Monitor hemodynamic status
• Administer medications and iv fluids
• Enhancing safety and comfort
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STATISTICS
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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 .
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- 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.
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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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THANK YOU FOR
LISTENING!!!