Acute heart failure

Acute pulmonary edema

Cariogenic shock

D-r Hristo Mateev

 Cardiogenic shock

• Cardiogenic shock is defined by sustained

hypotension with tissue hypoperfusion
despite adequate left ventricular filling
pressure. Signs of tissue hypoperfusion
include oliguria (<30 mL/h), cool extremities,
and altered level of consciousness.
• Signs and symptoms
• Anxiety, restlessness, altered mental state due to decreased cerebral perfusion and
subsequent hypoxia.
• Hypotension due to decrease in cardiac output.
• A rapid, weak, thready pulse due to decreased circulation combined with tachycardia.
• Cool, clammy, and mottled skin (cutis marmorata), due to vasoconstriction and
subsequent hypoperfusion of the skin.
• Distended jugular veins due to increased jugular venous pressure.
• Oliguria (low urine output) due to insufficient renal perfusion if condition persists.
• Rapid and deeper respirations (hyperventilation) due to sympathetic nervous system
stimulation and acidosis.
• Fatigue due to hyperventilation and hypoxia.
• Absent pulse in tachyarrhythmia.
• Pulmonary edema, involving fluid back-up in the lungs due to insufficient pumping of
the heart.
Pulmonary edema
• Chest X-ray will show fluid in the alveolar
walls, Kerley B lines, increased vascular
shadowing in a classical batwing peri-hilum
pattern, upper lobe diversion (increased blood
flow to the superior parts of the lung), and
possibly pleural effusions.