Cardiogenic Shock: What You Should Know

Maybe you’ve heard of a rare medical condition called cardiogenic shock and wondered exactly what it is. Simply put, it’s a form of heart failure where a lessthanadequate supply of blood is pumped from the heart to the brain, kidneys, lungs and other organs, making them unable to survive. According to Mark Pool, M.D., a cardiovascular and thoracic surgeon on the medical staff at Texas Health Dallas and at CVT Surgical Associates, a Texas Health Physicians Group practice, the circulatory system is so critically compromised with cardiogenic shock that it can be fatal to the patient, especially when not treated quickly.    

Pool says, “Cardiogenic shock is aptly named because it has a significant impact on the body. Suddenly, the heart muscle is damaged and cannot pump enough blood to the body’s tissues, and this collapse of the circulatory system means the patient isn’t achieving the proper blood flow needed to function. We often see the condition triggered by a heart attack or extreme heart failure, such as a valve problem in the patient.”

Signs of Cardiogenic Shock

In some cases, the patient will experience symptoms. In others, a friend, family member or caregiver will observe an abnormality. Symptoms or signs of cardiogenic shock may include some or a mix of:

  • Chest pain or discomfort
  • Confusion
  • Dizziness
  • Disorientation
  • Less urine output
  • Rapid breath/shortness of breath
  • Rapid heartbeat
  • Loss of consciousness
  • Weak pulse
  • Sweating
  • Pale skin
  • Cool to the touch, especially extremities
  • Low systolic (top number) blood pressure

Pool adds, “While these symptoms can appear in patients experiencing cardiogenic shock, in other cases, a friend or family member notices the patient doesn’t look right, that something is different or abnormal. Regardless of the symptoms, time is of the essence here, and it’s important to call 911 and get the patient to a hospital right away.”

The Cardiogenic Shock Initiative

Texas Health Dallas is one of 60 hospitals nationwide participating in The National Cardiogenic Shock Initiative to study the increase in patient survival rates using a newer medical technology called the Impella. This medical device is implanted in the femoral artery in the patient’s groin area and threaded to the heart’s left ventricle, known as the “pumping chamber,” restoring blood flow and pressure to normal levels.

“The Impella pumps five liters of blood through the body each minute, helping the heart function as intended,” says Pool. “It’s not an artificial heart, but rather a device that boosts the body’s circulatory function, and allows the heart to rest a bit. It gets blood flowing quickly to the body tissues where it’s needed most.”

Preventing Cardiogenic Shock

There are ways to minimize the potential for cardiogenic shock that involve lifestyle changes.  This list may look familiar: don’t smoke, maintain a healthy body weight, curb saturated fats and avoid trans fats in the diet, and last, limit sugar and alcohol. A regular exercise routine — as simple as 30 minutes a day — can also help lower blood pressure and improve overall heart health.

Importantly, there are some risk factors associated with cardiogenic shock. Older individuals, especially females, are more likely to experience the condition. People who have a history of heart failure or heart attack, and those with diabetes, high blood pressure or coronary artery disease also may be at risk.

Time is of the Essence

Pool emphasizes that time is of the essence when treating a cardiogenic shock patient, and that the quicker the physician team can restore the function of the heart, the better for the patient. If the patient’s blood flow is diminished after a certain amount of time, organs may be damaged, sometimes irreversibly. The Impella is one tool that enables the team at Texas Health Dallas to restore heart and circulatory function more quickly, so outcomes for the patient may be improved.

Bright Future Ahead

Pool believes that with time, research and the advent of new technologies, prospects for patients experiencing cardiogenic shock will improve.

Mark Pool, M.D., Cardiovascular and Thoracic Surgeon

“When compared to 40-50 years ago, we see significant improvements today in care and outcomes for patients,” he says. “There are so many new tools and proto

cols today to help the patient, and I think the future is especially bright with the use of the Impella. If the study shows that the device has a positive effect, as I believe it will, we’ll see it used more widely in the cardiovascular field.”

Texas Health Dallas’ multidisciplinary approach — teamwork between cardiologists and surgeons — means better outcomes for patients, and Pool believes that collaboration gives the heart and vascular team an edge in treating patients, and providing better outcomes for the patient. As Pool puts it, “That’s the whole point!”

If you’d like to learn more about cardiogenic shock, click on the link to watch Pool and his colleague James B. Park, M.D., FACC, explain the condition and its treatment on WFAA-TV.

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