Cardiogenic Shock Treatment

Cardiogenic shock occurs when the heart is unable to pump enough blood to meet the needs of the body. Often, cardiogenic occurs due to severe heart attack, but it can also occur after heart surgery, in patients with chronic heart congestive failure or with a severe heart disease such as cardiomyopathy. It can result in renal failure, respiratory failure and death.

As with other heart conditions, the best way to prevent cardiogenic shock is to practice good heart health — a healthy diet, exercise and quitting smoking. Talk to your provider if you have any questions.

Cardiogenic Shock Symptoms

It is crucial to recognize the symptoms early, as timely medical intervention can play a significant role in minimizing damage. Factors like persistent chest pain, rapid breathing, and confusion can be indicative of cardiogenic shock, necessitating immediate medical attention.

Understanding the causes and signs of this condition is paramount for initiating early preventive measures and ensuring better outcomes for at-risk patients.

As with other heart conditions, the best way to prevent cardiogenic shock is to practice good heart health — a healthy diet, exercise and quitting smoking. Talk to your provider if you have any questions.

Advanced Diagnostics

Given the seriousness of this condition, our team will work to diagnose and treat cardiogenic shock as quickly as possible by employing a comprehensive range of diagnostic methods. Many tests can be employed to confirm the diagnosis, starting with blood pressure measurement, since patients with cardiogenic shock typically exhibit very low blood pressure levels.

Additionally, blood tests are crucial as they help reveal organ function and detect substances that may indicate heart stress or damage. Imaging studies such as chest X-rays are also performed to look for any abnormalities in the lung or heart structure.

Echocardiograms come into play as they use ultrasound waves to create images of the heart, allowing doctors to evaluate the heart's function and structure in detail. In more complex cases, cardiac catheterization may be required, as it provides direct insights into the heart's pumping efficiency and potential blockages in the coronary arteries, helping tailor the most effective treatment strategy.

Learn more our advanced cardiovascular diagnostic tests.

Comprehensive Treatments for Cardiogenic Shock

The goal of treatment for cardiogenic shock is to restore blood pressure and heart function as quickly as possible to minimize the damage to the patient’s heart and other organs. Treatments often may begin in an emergency setting, with oxygen assistance and IV fluids to increase blood pressure or heart function.

Depending on the cause of cardiogenic shock, some patients may be prescribed medications as a first stage of treatment to stabilize the heart's function. These medications often include vasopressors and inotropes, which help improve the heart’s ability to contract and increase blood pressure - playing a crucial role in initially supporting the cardiovascular system.

When more advanced medical intervention is needed, our Cardiogenic Shock Team can provide patients with the full scope of mechanical circulatory devices to either temporarily support the heart as it recovers or serve as a bridge to surgical intervention to correct the problem within the heart.

Short-Term Mechanical Cardiac Pumps

These mechanical devices are critical in ensuring adequate blood flow when medication alone is insufficient. Short-term mechanical cardiac pumps used by our team of physicians to treat cardiogenic shock include:

• Impella^® — The Impella 5.0 heart pump is used as a short-term device to stabilize heart function and provide pumping support until further surgical intervention can be performed. This minimally invasive device is inserted into the heart via a catheter, usually inserted through the femoral artery in the groin. Once in place, the Impella 5.0 works by temporarily taking over the pumping action of the heart, allowing the heart muscle to rest and recover while enhancing blood flow to vital organs. Its use is critical in preventing further cardiac damage and in sustaining the patient until they are suitable for additional procedures, such as stent placement or coronary artery bypass surgery. By reducing the workload on the heart, the Impella 5.0 also contributes to improving overall patient outcomes, offering a vital bridge during the acute phase of cardiogenic shock.
   
• Extracorporeal Membrane Oxygenation (ECMO) — ECMO is used to quickly stabilize patients in cardiogenic shock by supporting cardiac function. This life-saving intervention works by oxygenating the blood outside of the body, allowing the heart and lungs to rest while maintaining vital organ perfusion. In many cases, ECMO serves as a critical bridge to recovery or further treatment, effectively supporting cardiac and respiratory function until the patient’s condition improves enough to withstand more definitive interventions. Patients who arrive in acute cardiac distress can benefit significantly from the rapid stabilization that ECMO provides, improving their overall prognosis by ensuring continued blood circulation while minimizing additional stress on the heart. As such, ECMO plays a pivotal role in the comprehensive management plan, giving healthcare teams the necessary time to develop specific long-term care strategies tailored to each patient’s unique needs.

These devices not only help stabilize heart function but also give us valuable time for cellular recovery and planning the next steps for long-term care. Through the careful application of these treatments, we aim to restore the patient's cardiac stability and prepare them for any further necessary interventions.

Heart Surgery to Treat Cardiogenic Shock 

Surgical interventions are often considered essential measures to address underlying heart issues that cause or contribute to cardiogenic shock. When further medical care is needed, our team of physicians may perform a surgical intervention to correct the problem within your heart. These surgical options can include:

• Coronary artery bypass grafting (CABG) — This procedure helps improve blood flow to the heart by rerouting blood around clogged arteries.
• Valve repair or replacement — Addresses malfunctioning heart valves that may hamper efficient blood circulation.
• VAD implant — Offers mechanical support to the heart's ventricle either temporarily or for extended periods.
• Heart transplant — In cases where heart damage is extensive and irreversible, a heart transplant might be the most viable option, replacing the damaged heart with a healthy donor heart to restore cardiac function.

Each of these procedures is designed to comprehensively address specific heart conditions contributing to cardiogenic shock, thus enhancing patient outcomes by promoting cardiac recovery and stability. Our expert cardiovascular team will evaluate each case to tailor the most appropriate and effective surgical plan, ensuring the best possible path to recovery.

Recovery After Cardiogenic Shock

Recovery after cardiogenic shock is a long process as patients can be in ICU for months at times. During this critical phase, close monitoring and continuous care are essential to ensure that the heart and other vital organs recover sufficiently.

Our multidisciplinary team will work with you and your family to provide you with a comprehensive rehabilitation plan tailored to your specific needs. This plan may include gradual physical therapy, nutritional guidance, and emotional support to help you regain strength and confidence.

We understand that recovery can be overwhelming, which is why we offer resources and support groups to help you and your loved ones navigate the journey back to health. Our ultimate goal is to assist you in achieving a full recovery, enabling you to return to your daily life with improved heart health.

Improved Chance of Survival

Nationally, patient survival rates for cardiogenic shock have improved, ranging from 55 - 69% in recently published studies, but the cardiogenic shock process at Froedtert Hospital has shown even further improvement in outcomes.

With the implementation of the cardiogenic shock process at Froedtert Hospital, we are now achieving survival rates of 78%.

To improve a patient’s chances of survival, our team advises referring physicians to make shock calls early. Early activation leads to the best possible outcomes.

Team Collaboration and Exceptional Staff

Our Cardiogenic Shock team brings together the expertise of advanced heart failure cardiologists and cardiovascular surgeons who quickly assess and determine a treatment plan for cardiogenic patients upon referral. Patients will also be supported by a dedicated team of anesthesiologists, intensivists and perfusionists. Our team is available 24/7 for the evaluation and management of cardiogenic shock patients. Learn more about our Cardiogenic Shock team.

Your other organs may require additional support while your heart is recovering or while you wait for surgery. We work with our pulmonary/lung team if you need to be put on a breathing machine to take the stress off your lungs. We also work with our kidney team if you need to be put on temporary dialysis.

Research

As members of an academic medical center, heart and vascular physicians are up-to-date on the latest research findings and treatment techniques. Our patients also have access to significant local and national research studies and clinical trials.