Cardiogenic Shock

Abstract

DEFINITION AND PATHOGENESIS

INCIDENCE

Cardiogenic shock is shock occurring after myocardial infarction. It has been variously described as occurring in 6%, 8%, 10%, 12% and 20% of patients with myocardial infarction.  Shock accompanies the onset of pain in few eases and most cases occur in the first twenty-four hours after infarction although they may occur several days after.

CLINICAL CRITERIA

The criteria for diagnosis of shock may vary with different authors (hence the anomalous 20% above) but,
in general, it is agreed that shock is suggested clinically by the following features: cold, clammy extremities, pallor and cyanosis, rapid, thready pulse, anuria or oliguria, anxiety, restlessness or apathy, and prolonged hypotension. The only objective assessment is of blood pressure and this alone does not define shock. Considerable variation may therefore be expected in diagnosis.

In view of the difficulties in defining the criteria for diagnosis of shock, the individual criteria and the interpretations placed upon them warrant further discussion.