Cardiogenic shock, cardiac arrest, and circulatory failure are life-threatening, and recognizing the underlying etiology and initiating treatment to promote perfusion are key to managing these patients and improving outcomes.
Our recent issue Advances in Cardiac Resuscitation in the Emergency Department reviews the current evidence on diagnosis and management of cardiogenic shock, including oxygen supplementation, red blood cell transfusion, vasopressors, and inotropes. A summary of the various mechanical circulatory support options, including inclusion/ exclusion criteria and admission and inter-facility transfer guidance, is included.
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Here are a few key points:
- Cardiac resuscitation involves 2 simultaneous actions: (1) interventions to promote perfusion; and (2) correction of the underlying etiology.
- Cardiac arrest is a severe form of cardiogenic shock (pulse cannot be palpated). Cardiac resuscitation is the treatment of cardiogenic shock.
- Presenting complaints of a patient in cardiogenic shock include dyspnea, chest pain, lower extremity edema, and altered mental status.
- Congestive heart failure that progresses to cardiogenic shock results in cool extremities, delayed capillary refill, narrow pulse pressure (PP), and altered mental status.