What Is Happening
Cardiogenic shock occurs when the heart cannot pump enough blood to meet the body's needs, often after a large myocardial infarction. The result is low cardiac output, hypotension, and organ hypoperfusion.
Presentation
Patients are often pale, cool, and diaphoretic with a weak, rapid pulse, low blood pressure, and chest pain. Lung sounds may include crackles because blood backs up into the lungs. Altered mental status indicates severe hypoperfusion.
Treatment
Give oxygen, keep the patient comfortable and warm, and transport urgently. Avoid large fluid boluses because they can worsen pulmonary edema, and do not give nitroglycerin to hypotensive patients. Request ALS support, who may use vasopressors.