Жүрек қызметінің бұзылуынан туындаған шок

Shock due to heart dysfunction

Cardiogenic shock is a medical emergency resulting from inadequate blood flow to the body's organs due to the dysfunction of the heart. Signs of inadequate blood flow include low urine production (<30 mL/hour), cool arms and legs, and decreased level of consciousness. People may also have a severely low blood pressure and heart rate. Causes of cardiogenic shock include cardiomyopathic, arrhythmic, and mechanical. Cardiogenic shock is most commonly precipitated by a heart attack. Treatment of cardiogenic shock depends on the cause with the initial goals to improve blood flow to the body. If cardiogenic shock is due to a heart attack, attempts to open the heart's arteries may help. Certain medications, such as dobutamine and milrinone, improve the heart's ability to contract and can also be used. When these measures fail, more advanced options such as mechanical support devices or heart transplantation can be pursued. Cardiogenic shock is a condition that is difficult to fully reverse even with an early diagnosis.

Cardiogenic shock is caused by the failure of the heart to pump effectively. It is due to damage to the heart muscle, most often from a heart attack or myocardial contusion. Other causes include abnormal heart rhythms, cardiomyopathy, heart valve problems, ventricular outflow obstruction (i. e. systolic anterior motion in hypertrophic cardiomyopathy), or ventriculoseptal defects. It can also be caused by a sudden decompressurization (e. g. in an aircraft), where air bubbles are released into the bloodstream (Henry's law), causing heart failure.

An intra aortic balloon pump is a device placed by a cardiac surgeon into the descending aorta. It consists of a small balloon filled with helium that helps the heart to pump blood by inflating during diastole (the resting phase of the cardiac cycle) and deflating during systole (the contracting phase of the cardiac cycle). Intra aortic balloon pumps do not directly increase cardiac output, but importantly, they decrease the amount of pressure that the heart has to pump against, thereby allowing for more blood flow and oxygen to be delivered to the heart muscles. Intra aortic balloon pumps have been around for several decades and are most commonly used first line of the mechanical circulatory support devices. Potential complications specific to an Impella device include hemolysis (shearing of the blood cells) as well as the formation of lesions on the heart valve, namely the mitral or aortic valves. Because Venous arterial extra corporeal membrane oxygenation is a very invasive procedure, it is not usually the first line chosen device for patients in cardiogenic shock and is often reserved only for patients who have not only cardiogenic shock but also respiratory failure and/or concomitant cardiac arrest. Complications of venous arterial extra corporeal membrane oxygenation include an air embolism, pulmonary edema, and blood clotting in the circuit machine.