Cardiogenic Shock - How Is Cardiogenic Shock Treated? - Treatment
Cardiogenic shock is life-threatening and requires rapid diagnosis and identification of the cause, and emergency medical treatment. Treatments include medicines, heart procedures, and medical devices to support or restore blood flow in the body and prevent organ damage.
Because cardiogenic shock is a serious medical condition affecting multiple body organs, a team of medical specialists usually provides care. Some medical devices may be used temporarily to stabilize or support you until a permanent device can be implanted or until a heart transplant can be performed.
For people who have severe organ damage and may not survive after cardiogenic shock, palliative care or hospice care may help them have a better quality of life with fewer symptoms.
Medicines
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Cardiogenic Shock - How Is Cardiogenic Shock Treated?
Medicine can help increase blood flow and protect against organ damage. Some medicines treat the underlying cause of cardiogenic shock, which is usually a heart attack. These medicines include:
- Anti-arrhythmia medicines to restore a regular heartbeat.
- Blood thinners or antiplatelet medicines to dissolve blood clots and reduce platelets that may be blocking the coronary arteries.
- Vasopressors and inotropes, such as norepinephrine and dobutamine, to increase blood pressure and blood flow out of the heart.
Procedures
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Cardiogenic Shock - How Is Cardiogenic Shock Treated?
The following medical procedures may be done right away to restore blood flow within your heart and throughout your body to prevent organ damage.
- Percutaneous cardiac intervention (PCI) to open coronary arteries that are narrowed or blocked by the buildup of plaque. A small mesh tube called a stent may be implanted after PCI to prevent an artery from narrowing again. Your doctor may repeat PCI later if any other coronary arteries are affected by plaque.
- Coronary artery bypass grafting (CABG) to improve blood flow to the heart. This procedure is usually done as soon as possible after a diagnosis of cardiogenic shock.
Medical devices
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Cardiogenic Shock - How Is Cardiogenic Shock Treated?
You may need a medical device to aid, restore, or maintain blood flow, which may prevent organ damage from cardiogenic shock. Temporary devices sometimes support people who are waiting for surgery to implant a permanent device or for a heart transplant.
- Extracorporeal membrane oxygenation (ECMO) circulates the blood and supplies oxygen to the body’s organs through a heart-lung machine outside of the body. For ECMO devices, tubes connect to the large blood vessels near the base of the neck. The device draws blood from the right side of the heart, pumps it through the oxygenator, and then returns it to the left side of the heart so the oxygen-rich blood can be delivered throughout the body.
- An intra-aortic balloon pump (IABP) is no longer recommended to be used alone in cardiogenic shock, but it may improve survival when used along with ECMO. An IABP may also be used temporarily for people who have cardiogenic shock due to heart failure until another procedure can be done. An IABP helps the weakened heart muscle to pump as much blood as it can to vital organs. The IABP is placed in the aorta , and a balloon at the tip of the device inflates and deflates to match the heart’s pumping rhythm.
- Percutaneous circulatory assist devices (PCADs), including ventricular assist devices (VADs), can help support your heart until it recovers or while you are waiting for a heart transplant. A PCAD can help your heart work better if you are not eligible for a heart transplant. Risks include blood clots, bleeding, infection, device malfunction, and right-sided heart failure if a left VAD was used.
Additional emergency treatment
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Cardiogenic Shock - How Is Cardiogenic Shock Treated?
Additional emergency treatments may include:
- Continuous kidney dialysis to filter wastes out of the blood if the kidneys were damaged.
- Fluids given through an intravenous (IV) line inserted in one of your blood vessels to maintain normal blood volumes.
- Mechanical breathing support, such as a ventilator to protect the airway and provide extra oxygen.
- Oxygen therapy so that more oxygen reaches the lungs, the heart, and the rest of the body.
Look for
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Cardiogenic Shock - How Is Cardiogenic Shock Treated?
- Research for Your Health will explain how we are using current research and advancing research to treat people who have cardiogenic shock and other complications of ischemic heart disease.
- Participate in NHLBI Clinical Trials discusses our open and enrolling clinical studies that are investigating treatments and diagnostic procedures that may help cardiogenic shock.
- Life After will explain what your doctor may recommend including life-long lifestyle changes, medical care, and follow-up to prevent your condition from recurring, getting worse, or causing complications.