Cardiogenic Shock
This paper will cover my experience while in the cardiac catheterization lab during clinical rotations. A 67 year old Caucasian male was emitted for emergent angioplasty with intracoronary stent placement for occlusive myocardial infarction resulting in cardiogenic shock. My paper will detail the medical diagnosis and nursing management of cardiogenic shock.
Medical Diagnosis
Cardiogenic shock is a term used to describe the heart’s inability to supply enough blood to the organs of the body. The heart becomes unable to pump enough volume of blood to meet the body’s demand creating a state of organ hypoperfusion (Goldman, 2010). If left uncorrected cardiogenic shock will result in total circulatory collapse and death. Estimates of mortality related to cardiogenic shock are 50% making this one of the most challenging types of shock to treat (Sole, 2009). However, advancements in diagnoses and treatment over the years have greatly increased the survivability of cardiogenic shock.
There are numerous conditions that contribute to cardiogenic shock however; acute myocardial infarction is the leading etiology (Sole, 2009). The ischemic event associated with an extensive myocardial infarction damages the heart muscle limiting the pumping action and decreasing cardiac output. Individuals with infarctions involving greater than 40% of the left ventricle are at the highest risk for developing cardiogenic shock (Gulanick, 2011). Only 10-19% of patients develop cardiogenic shock at the onset of myocardial infarction. The majority of cases of cardiogenic shock occur within the subsequent 48 hours commonly due to reinfarction (Goldman, 2010). Other causes of cardiogenic shock include left ventricular failure, dysrhythmias, myopathies including valves, cardiac tamponade, pericarditis, pulmonary hypertension and pulmonary embolism (Ignatavicius, 2010).
Pathophysiology
Cardiogenic shock has a downward spiraling pathophysiology that ultimately leads to hypoxemia and
Medical Diagnosis
Cardiogenic shock is a term used to describe the heart’s inability to supply enough blood to the organs of the body. The heart becomes unable to pump enough volume of blood to meet the body’s demand creating a state of organ hypoperfusion (Goldman, 2010). If left uncorrected cardiogenic shock will result in total circulatory collapse and death. Estimates of mortality related to cardiogenic shock are 50% making this one of the most challenging types of shock to treat (Sole, 2009). However, advancements in diagnoses and treatment over the years have greatly increased the survivability of cardiogenic shock.
There are numerous conditions that contribute to cardiogenic shock however; acute myocardial infarction is the leading etiology (Sole, 2009). The ischemic event associated with an extensive myocardial infarction damages the heart muscle limiting the pumping action and decreasing cardiac output. Individuals with infarctions involving greater than 40% of the left ventricle are at the highest risk for developing cardiogenic shock (Gulanick, 2011). Only 10-19% of patients develop cardiogenic shock at the onset of myocardial infarction. The majority of cases of cardiogenic shock occur within the subsequent 48 hours commonly due to reinfarction (Goldman, 2010). Other causes of cardiogenic shock include left ventricular failure, dysrhythmias, myopathies including valves, cardiac tamponade, pericarditis, pulmonary hypertension and pulmonary embolism (Ignatavicius, 2010).
Pathophysiology
Cardiogenic shock has a downward spiraling pathophysiology that ultimately leads to hypoxemia and
References: Bowden, Tracy, R.N. (2012). The Intra-aortic Balloon Pump: A Nursing Care Study. British Journal of Cardiac Nursing, 7(5): 222-229 Buerke, Michael, M.D., (2012). Cardiogenic Shock due to Myocardial Infarction: Diagnosis, Monitoring and Management Goldman, Lee, M.D., (2010). Cecil Textbook of Medicine (23rd edition). Gulanick, Meg, (2011). Nursing Care Plans. Diagnosis, Interventions and Outcomes (7th edition) Ignatavicius, Donna, R.N. (2010). Medical-Surgical Nursing. Patient-Centered Collaborative Care (6th edition) McAtee, Margaret, R.N. (2011). Cardiogenic Shock. Critical Care Nursing Clinics of North America, 23(4): 607-615. Reynolds, Harmony, M.D., (2008). Cardiogenic Shock. Current Concepts and Improving Outcomes Skidmore, Linda, R.N., (2011). Mosby’s Drug Guide for Nurses (9th edition). St. Louis, MO: Elsevier. Sole, Mary Lou, PhD, RN, (2009). Introduction to Critical Care Nursing (5th edition). St. Louis, MO: Elsevier.