Cardiogenic shock

Cardiogenic shock is an extreme degree of circulatory disorders characterized by a significant decrease in blood pressure
And contractility of the heart. This condition entails irregularities in the
The work of the kidneys and the nervous system. The heart loses the ability to expel blood in
Vessels and pump it. Cardiogenic shock causes vasodilation,
The pressure drops and blood does not enter the brain. There comes a sharp
Oxygen starvation, a person loses consciousness, and then in most cases
There is a fatal outcome.

The causes of this condition can be extensive myocardial infarction, if it is damaged more than 40%. Cardiogenic shock develops as a result of acute myocarditis, rupture of the partitions of the heart, arrhythmia, acute stenosis or acute failure of the heart valves. The state of shock can cause massive pulmonary embolism, which completely overlaps
Lumen of the trunk of the pulmonary arteries.

Clinical symptoms of shock are a sharp decrease in blood pressure to 50/20 mm Hg, cold extremities, loss of consciousness, wet and pale skin, tachycardia. On the extremities, veins lose their tonus, the kidneys stop working.

Factors affecting the onset of shock are extensive myocardial infarction, advanced age, diabetes, poisoning with cardiotoxic substances.

Cardiogenic shock, treatment

To determine focal lesions in the myocardium, an electrocardiogram is performed, which allows to determine the vastness, depth and
Localization of myocardial infarction. The ultrasound of the heart makes it possible to determine which department suffered, and to evaluate the contractile capacity of the organ. Cardiogenic shock is also diagnosed with the radiographic contrast method of vascular diagnostics.

Treatment is carried out in the intensive care unit. The main goal of therapy is to increase blood pressure to further supply blood to vital organs. Treatment of cardiogenic shock can be medicamentous and surgical. The patient is laid, raising his legs, to ensure blood supply to the brain. Carry out oxygen inhalation with
Using a mask, with a pronounced pain syndrome, intravenously promedol
Or morphine. To stabilize the arterial pressure, a solution
Rheopolyglucin or heparin. For better nutrition of the heart muscle, a glucose solution is administered with magnesium, potassium or insulin. To increase the heart rate, intravenously injected solution of Dobutamine, Dopamine, Noradrenaline or Adrenaline.

Resuscitation measures are carried out under the constant control over the work of all vital organs. Blood pressure and urine output are monitored. In the absence of the effect of medicamentous treatment, surgical procedures are carried out. In the first 8 hours after a heart attack, coronary angioplasty is effective, which allows you to restore
Contractility of the heart. Another method is intra-aortic
Counterpulsation. The method is based on mechanical injection of blood into the aorta and
Contributes to increased blood circulation in the coronary vessels.

Cardiogenic shock most often develops in the first hours after myocardial infarction, so its timely treatment is very important. The most light form is a reflex shock, which is quite easily amenable to cupping. The reactive form of cardiogenic shock occurs with necrotic lesion of the myocardium over 50%. Lethality in this case is close to 100%.

Despite the fact that new methods of treatment of cardiogenic shock are constantly being developed, the lethal outcome exceeds 85%. Therefore, the most
Effective treatment is prevention, in which the zone is limited
Heart attack and the pain syndrome is stopped.