Cardiogenic Shock - Life After - Life After

Follow your doctor’s instructions about your treatment plan.

• Get regular medical care. Ask your doctor how often you need to schedule visits for follow-up care.
• Take steps to prevent infection if you had a medical procedure or surgery. It is important to practice good hygiene and to properly clean and care for surgical incisions.
• Take your medicines as your doctor prescribes. Do not change the amount of your medicine or skip a dose unless your doctor tells you to.
• Tell your doctor if you have any new symptoms, if your symptoms worsen, or if you have problems with other medical conditions that may increase your risk for heart events.

Return to Treatment to review possible treatment options for cardiogenic shock.

Your doctor may recommend regular follow-up visits to monitor your condition and any medical device that supports your health after cardiogenic shock.

• If you have an implanted VAD or another type of medical device to help your heart work better, your doctor will check to make sure that the device is working properly. You will be given instructions on what to do if the device gives a warning that it is not working correctly.
• If your heart does not respond well enough to other treatments, your doctor may recommend a heart transplant. A total artificial heart may be an option for patients who had cardiogenic shock affecting both the left and right ventricles of the heart as they wait for a heart transplant. While you wait for a donor heart, you will need to follow your treatment plan carefully.

Because cardiogenic shock is usually a serious complication of ischemic heart disease, your doctor may recommend a heart-healthy lifestyle, which includes:

• Heart-healthy eating, such as the DASH (Dietary Approaches to Stop Hypertension) eating plan. A heart-healthy eating plan includes fruits, vegetables, and whole grains and limits saturated fats, trans fats, sodium, added sugars, and alcohol.
• Being physically active. Routine physical activity can help manage ischemic heart disease risk factors, such as high blood cholesterol, high blood pressure, or overweight and obesity.
• Aiming for a healthy weight. Losing just 3 percent to 5 percent of your current weight can help you manage some ischemic heart disease risk factors, such as high blood cholesterol and diabetes. Greater amounts of weight loss can also improve blood pressure readings.
• Managing stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.
• Quitting smoking. Visit Smoking and Your Heart and the National Heart, Lung, and Blood Institute’s Your Guide to a Healthy Heart. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, you can call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).

If your cardiogenic shock was a complication of ischemic heart disease, you may be referred for exercise-based cardiac rehabilitation, to manage symptoms and reduce the chances of future problems. Studies have shown that exercise-based cardiac rehabilitation reduces the risk of hospitalization and cardiovascular death. Many people who have participated in cardiac rehab also report better quality of life.

If you had cardiogenic shock following a heart attack, your doctor will work with you to manage medical conditions that can raise your risk for heart problems and complications.

• If you have diabetes you will need to check your blood sugar and keep taking any prescribed medicines.
• You may be given a statin to lower your LDL cholesterol .
• Your doctor may recommend aspirin to prevent a repeat heart attack. Low-dose aspirin may help prevent blood clots and reduce the risk for repeat heart attacks and other complications of ischemic heart disease for some people, including those who have diabetes.

Living with a heart condition may cause fear, anxiety, depression, and stress. Talk with your health care team about how you feel. Your doctor may recommend you take steps that include:

• Talking to a professional counselor. Your doctor may recommend medicines or other treatments that can improve your quality of life.
• Joining a patient support group. This may help you adjust to life after cardiogenic shock. You can find out how other people who have the same symptoms as yours have coped with them. Your doctor may be able to recommend local support groups, or you can check with an area medical center.
• Seeking support from family and friends. Letting your loved ones know how you feel and what they can do to help you can help relieve stress and anxiety.

A lack of oxygen-rich blood to the body can lead to problems throughout the body, including the heart, brain, and kidneys. Learn the warning signs of repeat heart attacks, stroke, and other complications of ischemic heart disease. Ischemic heart disease can lead to cardiogenic shock.

• Brain injury. Brain cells can begin to die within a few minutes after oxygen supply has been reduced or cut off. Symptoms include a short attention span, poor judgment, memory loss, and a decrease in physical coordination. Talk with your doctor about what to do if you or a loved one who had cardiogenic shock experiences the symptoms of brain injury.
• Heart attack. Signs and symptoms of heart attack include mild or severe chest pain or discomfort in the center of the chest or upper abdomen that lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, heartburn, or indigestion. There may also be pain down the left arm. Women may also have chest pain and pain down the left arm, but they are more likely to have less typical symptoms, such as shortness of breath, nausea, vomiting, unusual tiredness, and pain in the back, shoulders, or jaw.
• Kidney failure. Learn about the symptoms of kidney disease, which can begin so slowly that you may not notice the symptoms right away. Talk with your doctor about whether you need regular testing of your kidney function and early treatments.
• Liver damage. When the liver does not receive enough oxygen from the blood, the result can be a condition called Hypoxic hepatitis. Hypoxic hepatitis may go away when the cause of the cardiogenic shock is treated. Talk with your doctor about what tests you may need to monitor liver function and any special care or dietary changes you may need to care for your liver. Rarely, the liver may stop working after cardiogenic shock; this is called liver failure.
• Stroke. If you think someone may be having a stroke, act F.A.S.T. and perform the following simple test.
  F—Face: Ask the person to smile. Does one side of the face droop?
  A—Arms: Ask the person to raise both arms. Does one arm drift downward?
  S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
  T—Time: If you observe any of these signs, call 9-1-1 immediately. Early treatment is essential.

If a pulmonary embolism, a type of venous thromboembolism, caused your cardiogenic shock, your doctor will recommend follow-up treatment to break up or stabilize the clots and help blood flow return to normal. To prevent a repeat event, your doctor may adjust your medicine or treatment plan.