Cardiogenic Shock: NCLEX Priorities
Cardiogenic shock: low CO, high SVR, pulmonary congestion. Inotropes, intra-aortic balloon pump.
Cardiogenic shock is pump failure. NCLEX tests recognition vs other shocks and treatment.
Recognition
Hypotension + signs of poor perfusion + pulmonary congestion. Cold/clammy extremities. Decreased urine output. Altered mental status. Often post-MI.
Hemodynamics
Low CO, low CI, high SVR, elevated PCWP (left-sided fluid backup).
Treatment
Inotropes (dobutamine, milrinone). Vasopressors (norepi) if hypotensive. Intra-aortic balloon pump (IABP) for refractory. Reperfusion if MI cause. Mechanical circulatory support (Impella, ECMO) for refractory.
Frequently asked
vs septic shock?
Cardiogenic: cold, low CO, high SVR. Septic (warm phase): warm, high CO, low SVR.
IABP, how does it work?
Balloon inflates in diastole (improves coronary perfusion), deflates in systole (reduces afterload).
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